ADJUST: A Study on MDT Prognostication

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

323 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-10-15

Study Completion Date

2021-04-13

Brief Summary

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This study investigates how clinicians form intuitive judgements about the prognoses of palliative care patients after receiving advice perceived as coming from either a team member or an algorithm.

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Detailed Description

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Using the Judge-Advisor System, the investigators will recruit clinicians working in palliative care for adults. Participants will be asked to complete an online survey and review five patient summaries ("vignettes") based on real cases derived from a previous study. Clinicians will be presented with key prognostic information and will be asked to provide an estimate of the probability that the patient will survive for two weeks (0-100%). After providing this initial estimate, participants will receive prognostic advice. While in reality all participants will receive the same advice, participants will be randomised into two groups and these groups will be informed that the advice is either: (1) provided by an algorithm; or (2) provided by a team colleague. Participants will then be given the opportunity to give a second, possibly revised estimate in the light of the advice received.

Conditions

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Terminal Illness

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Participants were randomly assigned to one of two study arms and received advice reportedly from either a prognostic algorithm, or another clinician.

Primary Study Purpose

OTHER

Blinding Strategy

DOUBLE

Participants Investigators

The research team and participants were blind to intervention allocation, whilst the database specialist was not blinded to allocation. Group allocation was only revealed once the database had been locked and analyses had been completed.

Study Groups

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Algorithm Arm

Participants received prognostic advice from a prognostic algorihm.

Group Type EXPERIMENTAL

Advice from the PiPS-B14 prognostic tool

Intervention Type OTHER

Participants were informed that prognostic advice came from the PiPS-B14 prognostic tool. PiPS-B14 is a validated prognostic algorithm that has been shown to be as accurate as an agreed multi-professional survival estimate.

Participants were further informed that in a previous study the PiPS-B14 risk categories for predicting two-week survival were as accurate as a doctor's or a nurse's prediction.

Clinician arm

Participants recieved prognostic advice from another clinician.

Group Type EXPERIMENTAL

Advice from another clinician

Intervention Type OTHER

Participants were informed that prognostic advice came from another clinician.

Doctors were told that advice was from a nurse, whereas nurses or other types of HCPs were told that advice was from a doctor.

Interventions

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Advice from the PiPS-B14 prognostic tool

Participants were informed that prognostic advice came from the PiPS-B14 prognostic tool. PiPS-B14 is a validated prognostic algorithm that has been shown to be as accurate as an agreed multi-professional survival estimate.

Participants were further informed that in a previous study the PiPS-B14 risk categories for predicting two-week survival were as accurate as a doctor's or a nurse's prediction.

Intervention Type OTHER

Advice from another clinician

Participants were informed that prognostic advice came from another clinician.

Doctors were told that advice was from a nurse, whereas nurses or other types of HCPs were told that advice was from a doctor.

Intervention Type OTHER