An online international comparison of thresholds for triggering a negative response to the "Surprise Question": a study protocol
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An online international comparison of thresholds for triggering a negative response to the "Surprise Question": a study protocol. / 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; Stone, Patrick.
In: BMC PALLIAT CARE, Vol. 18, No. 1, 09.04.2019, p. 36.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - An online international comparison of thresholds for triggering a negative response to the "Surprise Question": a study protocol
AU - White, Nicola
AU - Oostendorp, Linda
AU - Vickerstaff, Victoria
AU - Gerlach, Christina
AU - Engels, Yvonne
AU - Maessen, Maud
AU - Tomlinson, Christopher
AU - Wens, Johan
AU - Leysen, Bert
AU - Biasco, Guido
AU - Zambrano, Sofia
AU - Eychmüller, Steffen
AU - Avgerinou, Christina
AU - Chattat, Rabih
AU - Ottoboni, Giovanni
AU - Veldhoven, Carel
AU - Stone, Patrick
PY - 2019/4/9
Y1 - 2019/4/9
N2 - 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.
AB - 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.
KW - Attitude of Health Personnel
KW - Attitude to Death
KW - Belgium
KW - General Practitioners/psychology
KW - Germany
KW - Humans
KW - Internet
KW - Italy
KW - Netherlands
KW - Palliative Care/methods
KW - Prognosis
KW - Surveys and Questionnaires
KW - Switzerland
KW - United Kingdom
U2 - 10.1186/s12904-019-0413-x
DO - 10.1186/s12904-019-0413-x
M3 - SCORING: Journal article
C2 - 30979361
VL - 18
SP - 36
JO - BMC PALLIAT CARE
JF - BMC PALLIAT CARE
SN - 1472-684X
IS - 1
ER -