Understanding Physician Signout Risk Perception

Completed

• Conditions: Physician Judgment
• Interventions: Other: Clinical deterioration

• Registration Number: NCT02648828
• Lead Sponsor: 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.

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.

Study Timeline

• Study Start: 2015-07
• Study First Submitted: 2015-07-20
• Study First Submitted QC: 2016-01-05
• Study First Posted: 2016-01-07
• Primary Completion: 2016-02
• Study Completion: 2016-02
• Status Verified: 2017-08
• Last Update Submitted: 2017-08-25
• Last Update Posted: 2017-08-28

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 132

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.

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Exclusion Criteria

• None

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Attendings	Clinical deterioration	Attendings are physicians who have completed their residency.
Residents	Clinical deterioration	Residents are in their 2nd or 3rd year of residency.
Intern	Clinical deterioration	Interns are in their first year of residency.

Primary Outcome Measures

Name	Time	Method
Difference between physician prediction of risk of clinical deterioration and Rothman Index	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.

Trial Locations

Locations (1)

University of Pittsburgh; 🇺🇸 Pittsburgh, Pennsylvania, United States