1. An online international comparison of thresholds for triggering a negative response to the 'Surprise Question': a study protocol
- Author
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Yvonne Engels, Johan Wens, Linda J. M. Oostendorp, Maud Maessen, Patrick Stone, Christina Gerlach, Bert Leysen, Nicola White, Carel Veldhoven, Christina Avgerinou, Guido Biasco, Steffen Eychmüller, Rabih Chattat, Giovanni Ottoboni, Christopher Tomlinson, Sofia C. Zambrano, Victoria Vickerstaff, White, Nicola, Oostendorp, Linda, Vickerstaff, Victoria, Gerlach, Christina, Engels, Yvonne, Maessen, Maud, Tomlinson, Christopher, Wens, Johan, Leysen, Bert, Biasco, Guido, Zambrano, Sofia, Eychmüller, Steffen, Avgerinou, Christina, Chattat, Rabih, Ottoboni, Giovanni, Veldhoven, Carel, and Stone, Patrick
- Subjects
Palliative care ,Survival ,Study Protocol ,0302 clinical medicine ,Belgium ,Germany ,Surveys and Questionnaires ,610 Medicine & health ,Netherlands ,Multiple choice ,media_common ,lcsh:RC952-1245 ,General Medicine ,Prognosis ,Death ,Surprise ,Italy ,Negative response ,030220 oncology & carcinogenesis ,0305 other medical science ,Psychology ,Switzerland ,medicine.medical_specialty ,Attitude to Death ,Attitude of Health Personnel ,Prognosi ,media_common.quotation_subject ,education ,lcsh:Special situations and conditions ,1117 Public Health and Health Services ,Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18] ,03 medical and health sciences ,Surprise question ,All institutes and research themes of the Radboud University Medical Center ,General Practitioners ,030502 gerontology ,medicine ,Humans ,National level ,Protocol (science) ,Internet ,Correction ,Certificate ,United Kingdom ,Vignette ,Family medicine ,Human medicine ,Gerontology - Abstract
Background The Surprise Question (SQ) “would I be surprised if this patient were to die in the next 12 months?” has been suggested to help clinicians, and especially General Practitioners (GPs), identify people who might benefit from palliative care. The prognostic accuracy of this approach is unclear and little is known about how GPs use this tool in practice. Are GPs consistent, individually and as a group? Are there international differences in the use of the tool? Does including the alternative Surprise Question (“Would I be surprised if the patient were still alive after 12 months?”) alter the response? What is the impact on the treatment plan in response to the SQ? This study aims to address these questions. Methods An online study will be completed by 600 (100 per country) registered GPs. They will be asked to review 20 hypothetical patient vignettes. For each vignette they will be asked to provide a response to the following four questions: (1) the SQ [Yes/No]; (2) the alternative SQ [Yes/No]; (3) the percentage probability of dying [0% no chance – 100% certain death]; and (4) the proposed treatment plan [multiple choice]. A “surprise threshold” for each participant will be calculated by comparing the responses to the SQ with the probability estimates of death. We will use linear regression to explore any differences in thresholds between countries and other clinician-related factors, such as years of experience. We will describe the actions taken by the clinicians and explore the differences between groups. We will also investigate the relationship between the alternative SQ and the other responses. Participants will receive a certificate of completion and the option to receive feedback on their performance. Discussion This study explores the extent to which the SQ is consistently used at an individual, group, and national level. The findings of this study will help to understand the clinical value of using the SQ in routine practice. Trial registration Clinicaltrials.gov NCT03697213 (05/10/2018). Prospectively registered. Electronic supplementary material The online version of this article (10.1186/s12904-019-0413-x) contains supplementary material, which is available to authorized users.
- Published
- 2019