Improving Personalized Treatment in Oncology: Effects of Integrated Oncological Decision-making

NCT ID: NCT07046884

Last Updated: 2025-07-02

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

RECRUITING

Clinical Phase

NA

Total Enrollment

400 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-25

Study Completion Date

2026-03-31

Brief Summary

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The research aims to evaluate an Integrated Oncological Decision-making Model (IODM) to tailor oncological treatment plans to individual patients. The primary objective is to assess the impact of the IODM on personalized decision-making and patient outcomes. The study will employ a stepped-wedge cluster randomized trial design involving eight oncological care paths across four medical centers in the Netherlands. The study population consists of 400 adult patients (50 per care path) who will undergo treatment based on either standard clinical guidelines (control) or the IODM (intervention). The intervention involves integrating three key components: oncological treatment options, patient's general health status, and patient's goals and preferences. The main study parameters include measuring the discordance between recommendations based on medical information and final treatment decisions, assessing whether discordance reflects more personalized decision-making, and evaluating the implementation process of the IODM.

Detailed Description

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Rationale: Currently, oncological treatment plans and decision-making are predominantly based on medical information following strict guidelines. Based on the conviction that oncological treatment plans can and should be more tailored to the individual, an outline for the Integrated Oncological Decision-making Model (IODM) has been developed. The IODM aims to individualize treatment decisions through the integration of patient's health status and goals/preferences in formulating treatment decisions.

Objectives: The primary objective of the current study is to evaluate the effect of the IODM on personalized decision-making and patient outcomes. We hypothesize that with the use of the IODM, decisions will more often differ from treatment recommendation based on clinical guidelines only, and that use of the IODM intervention will lead to more personalized decisions. The secondary objective of this study is to perform an extensive process evaluation of the implementation and strategies of the IODM.

Study design: The study will use a stepped-wedge cluster randomized trial design. Eight oncological care paths (clusters) will transition from current practice (control) to a locally tailored IODM-based practice (intervention condition) in four steps (two clusters per step), where order is determined by randomization.

Study population: Study participants will be a convenience sample of patients (n=400 total, n=50 per care path) from two oncological care paths per center, in four medical centers (LUMC, UMCG, MUMC+ and Zuyderland) in the Netherlands. The minimal age of participants is 18.

Intervention: In the IODM-based practice, the following three information components should be incorporated when forming a personalized treatment plan: 1. State-of-the-art oncological treatment options with advantages and disadvantages; 2. General health status based on physical, psychosocial, and emotional functioning; 3. Goals and preferences of the patient, both in treatment and daily life. Together with the professionals, optimal tools and strategies to integrate these components within the care path will be discussed.

Main study parameters/endpoints: Our primary outcome is the discordance between the treatment recommendation based on clinical guidelines and the final treatment decision. We will measure whether discordance is due to more personalized decision-making, using shared decision-making outcome measures, and assessment of IODM components.

Conditions

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Oncology

Study Design

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Allocation Method

NON_RANDOMIZED

Intervention Model

CROSSOVER

The study will use a stepped-wedge cluster randomized trial design. Eight oncological care paths (clusters) will transition from current practice (control) to a locally tailored IODM-based practice (intervention condition) in four steps (two clusters per step), where order is determined by randomization.
Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

SINGLE

Participants
Participants will not know whether their onocolgical care pathway has already integrated the IODM (intervention) or is practising care as usual (control)

Study Groups

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Current care pathway (Control condition)

In this arm the participants receive care as usual.

Group Type NO_INTERVENTION

No interventions assigned to this group

IODM integrated care pathway

In this arm the participants receive care within an oncological care path that has integrated the IODM within their daily practice

Group Type ACTIVE_COMPARATOR

Integrated Oncological Decision-making Model

Intervention Type BEHAVIORAL

In the IODM-based practice, the following three information components should be incorporated when forming a personalized treatment plan: 1. State-of-the-art oncological treatment options with advantages and disadvantages; 2. General health status based on physical, psychosocial, and emotional functioning; 3. Goals and preferences of the patient, both in treatment and daily life. Together with the professionals, optimal tools and strategies to integrate these components within the care path will be discussed.

Interventions

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Integrated Oncological Decision-making Model

In the IODM-based practice, the following three information components should be incorporated when forming a personalized treatment plan: 1. State-of-the-art oncological treatment options with advantages and disadvantages; 2. General health status based on physical, psychosocial, and emotional functioning; 3. Goals and preferences of the patient, both in treatment and daily life. Together with the professionals, optimal tools and strategies to integrate these components within the care path will be discussed.

Intervention Type BEHAVIORAL

Eligibility Criteria

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Inclusion Criteria

* Patient's age = 18+
* Patient is included in participating oncological care path
* Patient does not yet have a treatment plan
* Patient, partner, or caregiver who reads and speaks Dutch sufficiently to understand the research material and to complete the questionnaires
* Patient must be able to participate in the decision-making process

Exclusion Criteria

• Patient, partner, or caregiver cannot give informed consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Dutch Cancer Society

OTHER

Sponsor Role collaborator

Leiden University Medical Center

OTHER

Sponsor Role lead

Responsible Party

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lwelling

Dr. L. Welling

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Lieke Welling, MD PhD (Dr)

Role: PRINCIPAL_INVESTIGATOR

Department of Surgery

Locations

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University Medical Center Groningen (UMCG)

Groningen, , Netherlands

Site Status RECRUITING

Leiden University Medical Center (LUMC)

Leiden, , Netherlands

Site Status RECRUITING

Maastricht University Medical Center

Maastricht, , Netherlands

Site Status RECRUITING

Zuyderland MC

Sittard, , Netherlands

Site Status RECRUITING

Countries

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Netherlands

Central Contacts

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Lieke Welling, MD PhD (Dr)

Role: CONTACT

+31647140968

Facility Contacts

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Barbara van Leeuwen, Prof. MD.

Role: primary

Lieke Welling, MD PhD (Dr.)

Role: primary

Trudy van der Weijden, Prof.

Role: primary

Asiong Jie, Dr.

Role: primary

References

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Other Identifiers

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N23.071

Identifier Type: -

Identifier Source: org_study_id

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