Prognostic Estimates Among ICU Clinicians

ConditionMechanical Ventilation

Trial statusRecruiting

Trial phaseNot applicable

Trial typeInterventional

Biological sexAll

AgeNot listed

SponsorRush University Medical Center

About this trial

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.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

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.

Disqualifiers

None

Trial design

Design model

Parallel

Treatments tested in this trial

ProVent-14 score
Behavioral
A score to estimate one-year mortality for patients requiring at least 14 days of mechanical ventilation

Treatment groups

238 Participants

are divided into 2 treatment groups

Group A: Usual Prognostic ApproachNo intervention 0 interventions

Group B: ProVent-14 Guided Prognostic ApproachExperimental treatment 1 intervention

Trial 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

Other outcomes

Accuracy of factors influencing prediction

Participants will list up to 5 characteristics of the patient's situation that influenced their prediction

Time frame

One-year after participant enrollment

Sponsors and contacts

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Rush University Medical Center

Lead sponsor

University of North Carolina, Chapel Hill

Collaborator

Source ClinicalTrials.gov

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