Vignette-based Randomized Controlled Trial of the Decision Making Process of Bed Allocation in the Intensive Care Unit: Impact of Bed Availability and Cognitive Load.
试验速览
- 阶段
- 不适用
- 入组人数
- 178
- 主要终点
- simulated ICU admission rates
研究概览
简要总结
Decisions about ICU beds allocations are made everyday, specially in countries with scarcity of ICU beds, such as Brazil. ICU triage, most of the time, is not structured, which may lead to faulty decision making, possibly leading to bad clinical outcomes. It has been shown that external factors may influence the decision making process. The investigators intend to evaluate the impact of bed availability and cognitive load on the ICU bed allocation process by submitting groups of individuals to a vignette based randomized controlled trial simulating conditions with or without increased cognitive load and conditions with or without scarcity of ICU beds.
详细描述
Vignettes will be constructed based on consecutive patients for whom ICU bed was solicited. Vignettes will be validated through the evaluation of 8 experts in situations with or without bed scarcity. Vignettes with more than 80% concordance on ICU disposition (admission or refusion) will be used in the trial.
Intensive care doctors in Brazil will be asked to answer an online questionnaire with demographic characteristics and randomized to one of two groups. The experimental group will be submitted to increased cognitive load conditions, meaning that they will be encouraged to give their first impression on the vignettes, will have a time limit to answer the questions and will have popups with sound and videos, with the purpose to distract the respondents. The control group will be encouraged to think thoroughly and will have no time limit or distractions.
Vignettes will be presented, randomly, in conditions with or without scarcity of ICU beds to both groups. So, respondents with and without increased cognitive load will evaluate vignettes in conditions with and without scarcity of ICU beds.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 盲法
- None
入排标准
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •Intensive care unit doctors participating in specialty email lists
排除标准
- •Consent not provided
研究组 & 干预措施
Experimental
Subjected to increased cognitive load
干预措施: Increased cognitive load (Behavioral)
Control
Not subjected to increased cognitive load
结局指标
主要结局
simulated ICU admission rates
时间窗: 24 hours
difference on simulated ICU admission rates between the experimental and control groups, comparing to the expected allocation (designated by the experts that validated the vignettes and Society of Critical Care Medicine priority rank)
次要结局
- Time to complete the questionnaire(60 minutes)
研究者
João Gabriel Rosa Ramos
PhD Student
University of Sao Paulo General Hospital