Clinician JUdgment Versus Risk Score to Predict Stroke outComes:
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Unity Health Toronto
- Enrollment
- 111
- Locations
- 8
- Primary Endpoint
- 30 Day Mortality or Disability (mRS >3) at discharge
Study Overview
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 Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Diagnostic
- Masking
- Double (Investigator, Outcomes Assessor)
Eligibility Criteria
- Ages
- 20 Years to 75 Years (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Practicing and active physicians managing patients with stroke
Exclusion Criteria
- •retired physicians
- •physicians not exposed to care for stroke patients
Outcomes
Primary Outcomes
30 Day Mortality or Disability (mRS >3) at discharge
Time Frame: Death after 30 days from ischemic stroke onset or Disability following hospital discharge
Secondary Outcomes
- Death at 30 days(30 days)
- Death or institutionalization at discharge(up to 30 days after discharge)
Investigators
Gustavo Saposnik
Staff Physician and Clinician Scientist, Associate Professor of medicine, University of Toronto
Unity Health Toronto