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Decision Support for Parents Receiving Information About Child's Rare Disease (DSD DST)

This study is currently recruiting participants. (see Contacts and Locations)
Verified July 2014 by University of Michigan
Sponsor:
Collaborators:
Patient Centered Outcome Research Institute
Virginia Commonwealth University
Temple University
University of California, Los Angeles
Seattle Children's Hospital
Information provided by (Responsible Party):
Dr. David Sandberg, University of Michigan
ClinicalTrials.gov Identifier:
NCT01875640
First received: May 30, 2013
Last updated: July 10, 2014
Last verified: July 2014
  Purpose

The birth of a child with a disorder of sex development (DSD) is stressful for parents and members of the healthcare team. The "right" decisions about gender assignment (is it a boy? a girl?) and the best course of action (e.g., should there be surgery? what kind? when?) are not obvious. While there have been large advances in diagnostic assessments like genetic and endocrine testing, the tests do not always show what caused the DSD. And, even when the tests do reveal an explanation for the DSD, knowing what happened genetically or hormonally does not usually lead to a single "correct" treatment plan. Instead, it is likely that there are different acceptable treatment options - and parents will need to make decisions based, in part, on their personal preferences, values, and cultural background. Adding more stress to the situation is knowledge that many of the decisions that need to be made by parents early in a child's life are irreversible and exert life-long consequences for the child and the family.

To support parents becoming actively involved in making such decisions, and to reduce the likelihood of future worry and regret about decisions that have been made, the investigators will create a decision support tool (DST). The DST will help educate families about typical and atypical sex development of the body, the process by which DSD are diagnosed (especially how to interpret genetic test results), and possible relationships between diagnostic/genetic testing, decisions about care, and known consequences of those decisions on their child and entire family. The DST will be used by parents of young children together with their child's health care provider.

The investigators will bring together a network of researchers, health care providers, representatives of patient support and advocacy organizations, and parents of children with DSD to share their experiences. Participants of this network will be involved at each stage of creating the DST, revising it, and putting it into practice. At the end of this project, the investigators will have a fully formed and tested DST that will be available for parents to use with their child's health care team as they are first learning their child may have a DSD.


Condition Intervention
Disorder of Sex Development
Intersex Conditions
Congenital Adrenal Hyperplasia
Hypospadias
Behavioral: Decision Support Tool

Study Type: Interventional
Study Design: Allocation: Non-Randomized
Endpoint Classification: Efficacy Study
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Health Services Research
Official Title: Decision Support for Parents Receiving Information About Child's Rare Disease

Resource links provided by NLM:


Further study details as provided by University of Michigan:

Primary Outcome Measures:
  • Qualitative Assessment of Focus Groups, Usual Care and DST Implementation [ Time Frame: 2.5 years ] [ Designated as safety issue: No ]
    To assess characteristics of communications during focus groups and between health care providers and parents before and during the implementation of the DST audiofiles will be coded and analyzed using SCCAP (Siminoff Communication Content & Affect Program). SCCAP© is a new computerized coding scheme used to facilitate, organize, and code health communication data. It is designed so that coders can code directly from audio recordings, allowing the coder to take advantage of the vocalic cues inherent in speech intonations. Transcriptions can also be uploaded and coded so specific text can be viewed and tagged for future use.


Estimated Enrollment: 45
Study Start Date: June 2013
Estimated Primary Completion Date: March 2016 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
No Intervention: Usual Care
After obtaining consent, we will audio-record standard clinical consultations with specialists represented on the DSD team. These appointments will not utilize the Decision Support Tool. A qualitative analysis of these recordings will assess quality assurance and provide guidance for the development of the Decision Support Tool.
Experimental: Use of Decision Support Tool
After obtaining consent, we will audio-record standard clinical consultations with specialists represented on the DSD team. These appointments will utilize the Decision Support Tool (DST). A qualitative analysis of these recordings will assess the practicality of use and possible benefits of the DST's implementation.
Behavioral: Decision Support Tool
No Intervention: Focus Groups
Focus group members, recruited from advocacy organizations and by medical chart review, will provide feedback on the content and appearance of a preliminary Decision Support Tool (DST). Their comments will guide the development and implementation of the DST.

  Eligibility

Ages Eligible for Study:   up to 6 Years
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

  • Must be a parent/caregiver of a patient who is newborn through 5 years old (i.e., 5.9 yrs).
  • Patient clinical diagnosis of ambiguous genitalia (eg, 46,XX,Prader 2+; proximal hypospadias with uni/bilateral undescended testes) or sex chromosomes discordant with genital phenotype.
  • Condition must be newly ascertained. No surgical procedures (internal or external genitalia) have been performed or other decisions made (excluding those driven by medical urgency) regarding diagnostic testing or clinical management.

Exclusion Criteria:

  • Turner syndrome, Klinefelter syndrome, bladder or cloacal exstrophy.
  Contacts and Locations
Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below. For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01875640

Contacts
Contact: David E Sandberg, PhD 734-615-1958 dsandber@med.umich.edu

Locations
United States, California
University of California Los Angeles Recruiting
Los Angeles, California, United States, 90095
Contact: Eric Vilain, PhD, MD       evilain@ucla.edu   
Principal Investigator: Eric Vilain, Phd, MD         
United States, Michigan
University of Michigan Recruiting
Ann Arbor, Michigan, United States, 48104
Principal Investigator: David Sandberg, PhD         
United States, Virginia
Virginia Commonwealth University Not yet recruiting
Richmond, Virginia, United States, 23284
Contact: Laura Siminoff, PhD       lasiminoff@vcu.edu   
Principal Investigator: Laura Siminoff, PhD         
United States, Washington
Seattle Children's Hospital Recruiting
Seattle, Washington, United States, 98105
Contact: Margarett Shnorhavorian, MD, MPH       margarett.shnorhavorian@seattlechildrens.org   
Principal Investigator: Margarett Shnorhavorian, MD, MPH         
Principal Investigator: Patricia Fechner, MD         
Sponsors and Collaborators
University of Michigan
Patient Centered Outcome Research Institute
Virginia Commonwealth University
Temple University
University of California, Los Angeles
Seattle Children's Hospital
  More Information

No publications provided

Responsible Party: Dr. David Sandberg, Professor of Pediatrics, University of Michigan
ClinicalTrials.gov Identifier: NCT01875640     History of Changes
Other Study ID Numbers: 1360, 13-PAF00134, HUM72007
Study First Received: May 30, 2013
Last Updated: July 10, 2014
Health Authority: United States: Institutional Review Board

Keywords provided by University of Michigan:
disorder of sex development
intersex
46,XX congenital adrenal hyperplasia
hypospadias
decision support tool

Additional relevant MeSH terms:
Penile Diseases
Adrenal Hyperplasia, Congenital
Adrenocortical Hyperfunction
Adrenogenital Syndrome
Disorders of Sex Development
Hyperplasia
Hypospadias
Rare Diseases
Adrenal Gland Diseases
Congenital Abnormalities
Disease Attributes
Endocrine System Diseases
Genetic Diseases, Inborn
Genital Diseases, Male
Gonadal Disorders
Mental Disorders
Metabolic Diseases
Metabolism, Inborn Errors
Pathologic Processes
Sexual and Gender Disorders
Steroid Metabolism, Inborn Errors
Urogenital Abnormalities

ClinicalTrials.gov processed this record on November 27, 2014