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Completed

NCT Number: NCT03360812

ORaClES: A Trial to Improve Prognostication

This study evaluates whether an online training resource can improve the performance of medical students in recognising imminently dying palliative care patients.

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Key information

Conditions

Terminal Illness

Age range

18 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Brighton and Sussex Medical School, Brighton, United Kingdom

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About this study

Clinicians are routinely asked to provide survival estimates for palliative care patients, but recognition of imminent death (last 72 hours of life) is often inaccurate. We developed an online training resource, based on a previous study that identified the symptoms or signs that were most influential in forming expert palliative care doctors' prognostic decisions about imminent death.

This double-blind randomised controlled trial will evaluate the effectiveness of this online training resource in improving the performance of medical students in recognising imminently dying palliative care patients.

Participants are asked to visit the study website and review three series of vignettes describing patients referred to palliative care. For each vignette, participants are asked to provide an estimate (0-100%) about the probability that the patient will die in the next 72 hours. After the first series of vignettes, students randomised to the intervention arm are given access to an online training resource showing how experts weighted the relative importance of symptoms and signs. All participants are asked to complete a second series of vignettes. After two weeks, all participants are asked to return to the website and complete a third series of vignettes to assess if any effect has been maintained.

Who can participate

Healthy volunteers accepted: Yes

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

Inclusion criteria

  • Over 18 years of age
  • Enrolled on a registered medical course within the United Kingdom
  • In the penultimate or final year of medical school
  • Sufficient English language proficiency
  • Willing and able to provide consent as indicated by taking part in the online survey

Exclusion criteria

None

Treatment and study plan

Online training resource

Other

Please see information included in the description of the intervention group.

Primary outcomes

  1. Survival estimates - immediate effect

    Time frame: Second series of vignettes, taking into account the estimates from the first series. Students can participate at their convenience and will have a four week window to complete the first and second series of vignettes.

    The primary outcome will be a continuous survival estimate provided from the students for the second series of vignettes; ranging from 0-100%.

Secondary outcomes

  1. Survival estimates - follow-up

    Time frame: Third series of vignettes, taking into account the estimates from previous series. Two weeks after completing the first and second series of vignettes, students will be asked to complete a third series of vignettes within a four week window.

    Survival estimates provided from the students at the two week follow-up; ranging from 0-100%.

  2. Cue weighting

    Time frame: Change over time including all three series of vignettes. Students are given a four week window to complete the first and second series of vignettes. After two weeks, they will be asked to complete a third series of vignettes within a four week window.

    Cue weighting of the individual students as compared to the experts; that is the coefficient of each factor as part of their "judgement policy".

  3. Level of expertise

    Time frame: Change over time including all three series of vignettes. Students are given a four week window to complete the first and second series of vignettes. After two weeks, they will be asked to complete a third series of vignettes within a four week window.

    The level of expertise will be assessed with the Cochran-Weiss-Shanteau (CWS) score. This score details the level of ability to discriminate and the level of consistency.

Sponsors and collaborators

Lead sponsor

University College, London

Other

Collaborators

  • Brunel University
  • Hull York Medical School
  • Imperial College London
  • Marie Curie Hospice, Belfast

Registry information

Official study title

Online Randomised Controlled Trial to Improve Clinical Estimates of Survival (ORaClES)

Acronym: ORaClES

Important dates

Study start
2018
Primary completion
2018
Study completion
2018
First posted
Dec 4, 2017
Registry last updated
Apr 10, 2020

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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