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Understanding Physician Signout Risk Perception (UPS)

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ClinicalTrials.gov Identifier: NCT02648828
Recruitment Status : Completed
First Posted : January 7, 2016
Last Update Posted : August 28, 2017
Sponsor:
Collaborator:
Carnegie Mellon University
Information provided by (Responsible Party):
Janel Hanmer, University of Pittsburgh

Brief Summary:
The purpose of the study is to compare the ability of physicians and a statistical index (the Rothman score) to predict clinical deterioration over the next 24 hours. Clinical deterioration is defined as concern in change in vital signs or patient status requiring a call to the rapid response team, cardiopulmonary arrest, or transfer to the ICU.

Condition or disease Intervention/treatment
Physician Judgment Other: Clinical deterioration

Detailed Description:
The proposed study will ask interns, residents, and attending physicians from general internal medicine teaching teams in a large teaching hospital to make predictions about the probability of their patient having a clinical deterioration in the next 24 hours. The investigators will compare these judgments to the Rothman index.

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Study Type : Observational
Actual Enrollment : 132 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Understanding Physician Signout Risk Perception
Study Start Date : July 2015
Actual Primary Completion Date : February 2016
Actual Study Completion Date : February 2016

Group/Cohort Intervention/treatment
Intern
Interns are in their first year of residency.
Other: Clinical deterioration
Patients at risk of clinical deterioration

Residents
Residents are in their 2nd or 3rd year of residency.
Other: Clinical deterioration
Patients at risk of clinical deterioration

Attendings
Attendings are physicians who have completed their residency.
Other: Clinical deterioration
Patients at risk of clinical deterioration




Primary Outcome Measures :
  1. Difference between physician prediction of risk of clinical deterioration and Rothman Index [ Time Frame: Six months ]
    Physicians will make judgments about the probability of clinical deterioration for each of their patients on a 0 (definitely won't) to 100 (certainly will) scale. Clinical deterioration is defined as rapid response, cardiopulmonary arrest, or ICU transfer in the next 24 hours. The Rothman Index is an index that predicts clinical deterioration. The area under the receiver operating curve (AUROC) will be calculated for physicians and the Rothman Index. The AUROC measures the association between the physician's judgment or Rothman Index and actual clinical deterioration. The AUROC of these two measures will then be statistically compared.



Information from the National Library of Medicine

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Ages Eligible for Study:   18 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
Cohorts will be selected from the teaching teams of the University of Pittsburgh's General Internal Medicine wards.
Criteria

Inclusion Criteria:

  • Interns, residents, attendings in the Department of Medicine, Division of General Internal Medicine, University of Pittsburgh.
  • Rotating on the general medical service at the University of Pittsburgh Medical Center - Presbyterian Hospital.

Exclusion Criteria:

  • None

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT02648828


Locations
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United States, Pennsylvania
University of Pittsburgh
Pittsburgh, Pennsylvania, United States, 15213
Sponsors and Collaborators
University of Pittsburgh
Carnegie Mellon University
Investigators
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Principal Investigator: Janel A Hanmer, M.D. University of Pittsburgh
Principal Investigator: Deepika Mohan, MD University of Pittsburgh
Principal Investigator: Alex Davis, PhD Carnegie Mellon University

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Responsible Party: Janel Hanmer, Assistant Professor, University of Pittsburgh
ClinicalTrials.gov Identifier: NCT02648828     History of Changes
Other Study ID Numbers: PRO15040582
First Posted: January 7, 2016    Key Record Dates
Last Update Posted: August 28, 2017
Last Verified: August 2017
Keywords provided by Janel Hanmer, University of Pittsburgh:
Judgment
risk assessment
clinical deterioration
cardiac arrest
Rothman Index