ADJUST: A Study on MDT Prognostication

Terminal Illness Clinical Trial

— ADJUST  

Official title:

Study of Advice and Decision-making on Prognosis Using the Judge-advisor System Within Multi-disciplinary Teams (ADJUST)

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT04568629
• Other study ID #: 17031/001
• Status: Completed
• Phase: N/A
• Start date: October 15, 2020
• Est. completion date: April 13, 2021

Study information

• Verified date: September 2021
• Source: University College, London
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial Summary

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.

Description:

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 323
• Est. completion date: April 13, 2021
• Est. primary completion date: April 13, 2021
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 18 Years and older

Eligibility

Inclusion Criteria:

• Clinicians working in an adult palliative care service

• Willing and able to provide written informed consent

Exclusion Criteria:

• None

Related Conditions & MeSH terms

• Terminal Illness

Intervention

Other:
• 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.
• 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.

Locations

Country	Name	City	State
United Kingdom	University College London	London

Sponsors (1)

Lead Sponsor	Collaborator
University College, London

Country where clinical trial is conducted

United Kingdom, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Probability of survival estimate	Clinicians' estimates of the probability of a patient surviving for two weeks (0-100%)	Participants will have up to 7 months (until the study closes) to provide an estimate for each vignette
Secondary	Participants' weighting policies (characteristics of the participants)	Participants' responses to demographic questions	Participants will have up to 7 months (until the study closes) to provide an estimate for each vignette
Secondary	Participants' weighting policies (the advice itself)	Strength of the prognostic advice provided by the advisor (0-100%)	Participants will have up to 7 months (until the study closes) to provide an estimate for each vignette