Prognostic Estimates Among ICU Clinicians

Rush University Medical Center238 enrolled

Overview

One challenge with decision making for mechanically ventilated is that their prognosis is often uncertain. The ProVent-14 score incorporates clinical variables measured on the 14th day of mechanical ventilation to predict risk of death in one year. The ProVent-14 is easy to calculate has been externally validated. However, it is unclear how often clinicians use the ProVent-14 score to predict long-term outcomes for patients requiring 14 days of mechanical ventilation or if it helps clinicians make more accurate predictions. The purpose of this study is to determine whether ICU clinicians who receive a patient's ProVent-14 score make more accurate predictions for mortality at one year than ICU clinicians who do not.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Enrollment

238

Conditions

Mechanical Ventilation

Interventions

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * ICU day-shift attending physician, fellow physician, advanced practice provider, or nurse * Caring directly for a patient who requires invasive mechanical ventilation, 14-16 days after initial intubation, not actively transitioning to comfort-focused care and not with a neuromuscular disease (i.e. ALS) as a cause of respiratory failure. Exclusion Criteria: * None

Locations (3)

Rush University Medical Center

Chicago, Illinois, United States

RECRUITING

Rush Oak Park Hospital

Oak Park, Illinois, United States

ACTIVE_NOT_RECRUITING

University of North Carolina

Chapel Hill, North Carolina, United States

RECRUITING

Outcomes

Primary Outcomes

Accuracy of one-year mortality rate predictions

Associations between participant predictions (0-100% risk of death) and patient outcomes (death or not) will be determined using logistic regression. Accuracy will be determined by Area Under the Receiver Operating Characteristic (AUROC) analysis.

Time frame: One-year after participant enrollment

Secondary Outcomes

Confidence in prediction

1-10 scale, 10 being most confident

Time frame: Upon enrollment

Comfort communicating prognosis to patient/surrogate

1-10 scale, 10 being most comfortable

Time frame: Upon enrollment

Recommendation to transition to comfort-focused care

Yes or No

Time frame: Upon enrollment

Accuracy of timing of patient death

Participants who predict the patient has a \<50% chance of survival will be asked to predict the month the patient will pass away

Time frame: One-year after participant enrollment

Prognostic Estimates Among ICU Clinicians

Overview

Conditions

Interventions

Eligibility

Locations (3)

Outcomes

Primary Outcomes

Secondary Outcomes

Central Contacts