Clinician JUdgment Versus Risk Score to Predict Stroke outComes: The JURASSIC Clinical Trial

Not Applicable

Completed

• Conditions: Ischemic Stroke; Cerebrovascular Disease; Stroke
• Interventions: Other: Clinical scenarios

• Registration Number: NCT01657279
• Lead Sponsor: Unity Health Toronto

Brief Summary

Background: Several risk score models are now available to assist clinicians estimate outcomes after an acute ischemic stroke. Limited information is available on the predictive value of these scores compared to real outcomes and clinical judgment.

Objectives: To compare clinician judgment with the use of a validated stroke risk score (iScore) and patients' outcomes.

Detailed Description

A convenience sample of 111 practicing clinicians (general and vascular neurologists, internists, and ER physicians) predicted the outcomes of 5 stroke patients based on case summaries. Cases were randomly selected as being representative of the 10 most common clinical scenarios (n=1,415) from a pool of over 12,000 patients admitted to stroke centers in Ontario, Canada. Stroke cases had known clinical presentation, comorbidities, stroke severity, and outcomes.

All participants are active practicing physicians caring for patients with acute stroke. Conditions were standardized to mimic clinical practice.

Main outcomes of interest included 30-day mortality and death or disability at discharge.

Secondary outcome: death or institutionalization at discharge

Study Timeline

• Study Start: 2012-07
• Study First Submitted: 2012-07-30
• Primary Completion: 2012-08
• Study Completion: 2012-08
• Study First Submitted QC: 2012-08-03
• Study First Posted: 2012-08-06
• Status Verified: 2012-10
• Last Update Submitted: 2012-10-27
• Last Update Posted: 2012-10-30

Recruitment & Eligibility

• Status: COMPLETED
• Sex: All
• Target Recruitment: 111

Inclusion Criteria

• Practicing and active physicians managing patients with stroke

Exclusion Criteria

• retired physicians
• physicians not exposed to care for stroke patients

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Randomized clinical scenarios	Clinical scenarios	Clinicians are randomized to a sequence of 5 clinical scenarios

Primary Outcome Measures

Name	Time	Method
30 Day Mortality or Disability (mRS >3) at discharge	Death after 30 days from ischemic stroke onset or Disability following hospital discharge

Secondary Outcome Measures

Name	Time	Method
Death at 30 days	30 days
Death or institutionalization at discharge	up to 30 days after discharge

Trial Locations

Locations (4)

Duke University Medical Center; 🇺🇸 Durham, North Carolina, United States

St Michael's Hospital; 🇨🇦 Toronto, Ontario, Canada

McGill University Health Centre; 🇨🇦 Montreal, Quebec, Canada

Sunnybrook Health Sciences Centre; 🇨🇦 Toronto, Ontario, Canada