An online randomised controlled trial of prognosticating imminent death in advanced cancer patients: Clinicians give greater weight to advice from a prognostic algorithm than from another clinician with a different profession

Autor: Andrea Bruun, Nicola White, Linda Oostendorp, Victoria Vickerstaff, Adam J. L. Harris, Christopher Tomlinson, Steven Bloch, Patrick Stone
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Cancer Medicine, Vol 12, Iss 6, Pp 7519-7528 (2023)
Druh dokumentu: article
ISSN: 2045-7634
DOI: 10.1002/cam4.5485
Popis: Abstract Background A second opinion or a prognostic algorithm may increase prognostic accuracy. This study assessed the level to which clinicians integrate advice perceived to be coming from another clinician or a prognostic algorithm into their prognostic estimates, and how participant characteristics and nature of advice received affect this. Methods An online double‐blind randomised controlled trial was conducted. Palliative doctors, nurses and other types of healthcare professionals were randomised into study arms differing by perceived source of advice (algorithm or another clinician). In fact, the advice was the same in both arms (emanating from the PiPS‐B14 prognostic model). Each participant reviewed five patient summaries. For each summary, participants: (1) provided an initial probability estimate of two‐week survival (0% ‘certain death’—100% ‘certain survival’); (2) received advice (another estimate); (3) provided a final estimate. Weight of Advice (WOA) was calculated for each summary (0 ‘100% advice discounting’ – 1 ‘0% discounting’) and multilevel linear regression analyses were conducted. Clinical trial registration number: NCT04568629. Results A total of 283 clinicians were included in the analysis. Clinicians integrated advice from the algorithm more than advice from another clinician (WOA difference = −0.12 [95% CI ‐0.18, −0.07], p
Databáze: Directory of Open Access Journals
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