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Completed

NCT Number: NCT04568629

ADJUST: A Study on MDT Prognostication

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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Key information

Conditions

Terminal Illness Death Pathologic Processes Pathological Conditions, Signs and Symptoms

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

University College London

London, WC1E 6BT, United Kingdom

About this study

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.

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Clinicians working in an adult palliative care service
  • Willing and able to provide written informed consent

Exclusion criteria

  • None

Treatment and study plan

Advice from the PiPS-B14 prognostic tool

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.

Advice from another clinician

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.

Primary outcomes

  1. Probability of survival estimate

    Time frame: Participants will have up to 7 months (until the study closes) to provide an estimate for each vignette

    Clinicians' estimates of the probability of a patient surviving for two weeks (0-100%)

Secondary outcomes

  1. Participants' weighting policies (characteristics of the participants)

    Time frame: Participants will have up to 7 months (until the study closes) to provide an estimate for each vignette

    Participants' responses to demographic questions

  2. Participants' weighting policies (the advice itself)

    Time frame: Participants will have up to 7 months (until the study closes) to provide an estimate for each vignette

    Strength of the prognostic advice provided by the advisor (0-100%)

Sponsors and collaborators

Lead sponsor

University College, London

Other

Registry information

Official study title

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

Acronym: ADJUST

Important dates

Study start
2020
Primary completion
2021
Study completion
2021
First posted
Sep 29, 2020
Registry last updated
Jan 10, 2022

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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