Medical Triage in a Time of Scarce Resources.

NCT ID: NCT04982770

Last Updated: 2022-09-13

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

UNKNOWN

Clinical Phase

NA

Total Enrollment

500 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-11-01

Study Completion Date

2022-11-30

Brief Summary

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The XPHI-COVID-2 randomized study aims to investigate the moral choices in a context of scarce resources.

The participants are asked to complete the questionnaire of the Oxford Utilitarianism Scale and are exposed to medical triage dilemmas.

Participants are randomized between a group with reading of ethical guidelines and a group without reading of ethical guidelines, before they are asked to complete the questionnaire and being exposed to triage dilemmas.

Detailed Description

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It is hypothesized that recalling ethical values before resolving dilemmas could modify the ability to adopt a utilitarian approach in resolving ethical dilemmas.

To verify this hypothesis, the score on the Impartial Harm subscale of the Oxford Utilitarianism Scale (IH-OUS) will be compared between a group with reading of ethical guidelines and a group without reading of ethical guidelines, before they are asked to complete the questionnaire and being exposed to triage dilemmas.

Number of subjects needed for the phase of study evaluating intensivists, anesthesiologists and emergency physicians : 580 - based on preliminary data, assuming 70% complete response rate of the survey and a standard deviation of 5

Secondary outcomes will be considered :

* Beneficence Harm subscale of the Oxford Utilitarianism Scale (IB-OUS)
* Values prioritized to resolve ethical dilemmas : impartial of benefits, prioritization of the young age, saving life years, saving most lives, equality of treatment, prioritization of the worst off, loyalty duty, principle of non-discrimination, prospective and retrospective instrumental value.

First phase of the study will aim to include first-line caregivers : intensivists, anesthesiologists, emergency physicians.

Other phases of the study will aim to include health care professionals from other categories and non health care professionals.

Subgroup analyses are planned :

* Analysis according to the characteristics of the participant: gender, geographic location, diploma and type of exercise, category of institution to which the participant is attached.
* Analysis according to the degree of knowledge in ethics, the degree of familiarity with ethical recommendations, the degree of familiarity with moral philosophy, the degree of religiosity, whether the participants declare to have taken knowledge or not of recommendations concerning medical triage in a situation of scarce resources.

It is also planned to carry out ancillary studies in parallel with the realization of the study presented here:

* A study including non-physician participants aiming to identify the differences between non-physicians and physicians in terms of ethical values mobilized in medical triage.
* A study including medical students aiming to identify an association between propensity to make utilitarian and choices of the medical specialty.
* A study focused on the Oxford Utilitarianism Scale, integrating the results of the pilot study and the confirmatory study, aiming to identify predictors of responses to the dilemmas proposed within the scale.
* A study evaluating the association between delay in ethical dilemmas resolution and utilitarian choices.

Conditions

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Morals Covid19 Ethics, Narrative

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

OTHER

Blinding Strategy

TRIPLE

Participants Investigators Outcome Assessors

Study Groups

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Intervention

The participants have to read ethical guidelines before they are asked to complete the questionnaire of the Oxford Utilitarianism Scale and exposed to medical triage dilemmas.

Group Type EXPERIMENTAL

Survey

Intervention Type OTHER

Reading of ethical guidelines.

No intervention

The participants do not have to read ethical guidelines before they are asked to complete the questionnaire of the Oxford Utilitarianism Scale and exposed to medical triage dilemmas.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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Survey

Reading of ethical guidelines.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Caregivers
* Noncaregivers from general population

Exclusion Criteria

* Withdrawal of agreement
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Geneva, Switzerland

OTHER

Sponsor Role collaborator

University Hospital, Caen

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Clément GAKUBA, MD PhD

Role: PRINCIPAL_INVESTIGATOR

University Hospital, Caen

Locations

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Caen University Hospital

Caen, Calvados, France

Site Status RECRUITING

Countries

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France

Central Contacts

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Clément GAKUBA, MD PhD

Role: CONTACT

+33231064736

Florian COVA, PhD

Role: CONTACT

Facility Contacts

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Clément GAKUBA, MD

Role: primary

+33231064736

References

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Kahane G, Everett JAC, Earp BD, Caviola L, Faber NS, Crockett MJ, Savulescu J. Beyond sacrificial harm: A two-dimensional model of utilitarian psychology. Psychol Rev. 2018 Mar;125(2):131-164. doi: 10.1037/rev0000093. Epub 2017 Dec 21.

Reference Type BACKGROUND
PMID: 29265854 (View on PubMed)

Everett JAC, Faber NS, Savulescu J, Crockett MJ. The costs of being consequentialist: Social inference from instrumental harm and impartial beneficence. J Exp Soc Psychol. 2018 Nov;79:200-216. doi: 10.1016/j.jesp.2018.07.004.

Reference Type BACKGROUND
PMID: 30393392 (View on PubMed)

Emanuel EJ, Persad G, Upshur R, Thome B, Parker M, Glickman A, Zhang C, Boyle C, Smith M, Phillips JP. Fair Allocation of Scarce Medical Resources in the Time of Covid-19. N Engl J Med. 2020 May 21;382(21):2049-2055. doi: 10.1056/NEJMsb2005114. Epub 2020 Mar 23. No abstract available.

Reference Type BACKGROUND
PMID: 32202722 (View on PubMed)

Other Identifiers

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1475

Identifier Type: -

Identifier Source: org_study_id

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