Default Options to Reduce Unnecessary Daily Imaging During Palliative Radiation

Cancer Clinical Trial

Official title:

Health System Initiative to Reduce Unnecessary Daily X-Ray Image Guidance During Palliative Radiation Treatment

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03110692
• Other study ID #: 826810
• Status: Completed
• Phase: N/A
• Start date: February 10, 2016
• Est. completion date: February 9, 2018

Study information

• Verified date: November 2019
• Source: University of Pennsylvania
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

The goal of this study is to reduce preference sensitive, unnecessary daily imaging during radiation treatment in which a pre-planned quality improvement default option for radiation treatment prescriptions will be introduced throughout the network of Penn Radiation Oncology.

Description:

The goal of this study is to reduce preference sensitive, unnecessary daily imaging during radiation treatment in which a pre-planned quality improvement default option for radiation treatment prescriptions will be introduced throughout the network of Penn Radiation Oncology. This study is a prospectively designed, observational trial with two comparison groups: (1) a usual practice group (control group) and (2) a default radiation treatment prescription group (intervention group), in which the usual practice group will subsequently rollover from control to intervention so that all sites and physicians in the practice network of Penn Radiation Oncology are exposed to intervention. The purpose of this study is to reduce preference sensitive, unnecessary daily imaging during radiation treatment with the implementation of a quality improvement initiative within 5 sites of Penn Radiation Oncology. We aim to leverage the introduction of a default prescription option to reduce the use of daily imaging in palliative intent cases where it has limited clinical benefit and adds to cost burden. Our objective is to encourage more patient-centric clinical practice.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 1188
• Est. completion date: February 9, 2018
• Est. primary completion date: October 9, 2017
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Radiation treatment courses with palliative intent

• Palliative treatment of bone, soft tissue, and intracranial metastases

• Photon radiation with 3D conformal therapy (3DCRT) only

Exclusion Criteria:

• Use of intensity modulated radiation (IMRT) or stereotactic body radiation (SBRT) as radiation treatment modality

• Retreatment to same site

• Proton radiation

Related Conditions & MeSH terms

• Cancer

Intervention

Behavioral:
• Default initiation
A default prescription template will be introduced in the palliative setting in order to reduce unnecessary daily image guided radiation.

Locations

Country	Name	City	State
United States	University of Pennsylvania Health System	Philadelphia	Pennsylvania

Sponsors (1)

Lead Sponsor	Collaborator
University of Pennsylvania

Country where clinical trial is conducted

United States, 

References & Publications (1)

Sharma S, Guttmann D, Small DS, Rareshide CAL, Jones J, Patel MS, Bekelman JE. Effect of Introducing a Default Order in the Electronic Medical Record on Unnecessary Daily Imaging During Palliative Radiotherapy for Adults With Cancer: A Stepped-Wedge Cluster Randomized Clinical Trial. JAMA Oncol. 2019 Jun 27. doi: 10.1001/jamaoncol.2019.1432. [Epub ahead of print] — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Percent of Patients Receiving Daily Imaging	Radiology tests including x-rays and CT scans	3 months post arm crossover