Mechanical Ventilation
Conditions
Brief summary
One challenge with decision making for mechanically ventilated is that their prognosis is often uncertain. The ProVent-14 score incorporates clinical variables measured on the 14th day of mechanical ventilation to predict risk of death in one year. The ProVent-14 is easy to calculate has been externally validated. However, it is unclear how often clinicians use the ProVent-14 score to predict long-term outcomes for patients requiring 14 days of mechanical ventilation or if it helps clinicians make more accurate predictions. The purpose of this study is to determine whether ICU clinicians who receive a patient's ProVent-14 score make more accurate predictions for mortality at one year than ICU clinicians who do not.
Interventions
BEHAVIORALProVent-14 score
A score to estimate one-year mortality for patients requiring at least 14 days of mechanical ventilation
Sponsors
University of North Carolina, Chapel Hill
Rush University Medical Center
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
* ICU day-shift attending physician, fellow physician, advanced practice provider, or nurse * Caring directly for a patient who requires invasive mechanical ventilation, 14-16 days after initial intubation, not actively transitioning to comfort-focused care and not with a neuromuscular disease (i.e. ALS) as a cause of respiratory failure.
Exclusion criteria
* None
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Accuracy of one-year mortality rate predictions | One-year after participant enrollment | Associations between participant predictions (0-100% risk of death) and patient outcomes (death or not) will be determined using logistic regression. Accuracy will be determined by Area Under the Receiver Operating Characteristic (AUROC) analysis. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Confidence in prediction | Upon enrollment | 1-10 scale, 10 being most confident |
| Comfort communicating prognosis to patient/surrogate | Upon enrollment | 1-10 scale, 10 being most comfortable |
| Recommendation to transition to comfort-focused care | Upon enrollment | Yes or No |
| Accuracy of timing of patient death | One-year after participant enrollment | Participants who predict the patient has a \<50% chance of survival will be asked to predict the month the patient will pass away |
Other
| Measure | Time frame | Description |
|---|---|---|
| Accuracy of factors influencing prediction | One-year after participant enrollment | Participants will list up to 5 characteristics of the patient's situation that influenced their prediction |
Countries
United States
Contacts
Primary ContactJared Greenberg, MD
Outcome results
None listed