The Surprise Study

Study Overview
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Brief Summary
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This study investigates the use of the Surprise Question [SQ] (would you be surprised if this patient were to die in the next 12 months?) in routine practice. In particular, the study will investigate the consistency of the responses to the SQ and the relationship with the subsequent course of action decided upon.

Detailed Description
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Whilst the original use of the Surprise Question was to identify people who might be in the last year of life and benefit from palliative care, the prognostic capability of the Surprise Question has been shown to be variable. What is unclear, is the extent to which a doctor should be surprised before a patient is suitable for palliative care, how consistently doctors respond to this question, and how the subsequent treatment decision relates to the SQ response. The study will recruit 600 General Practitioners (GPs) from 6 participating countries (100 per country; UK, Germany, Switzerland, Italy, Belgium, the Netherlands). Each participant will asked to complete a series of 20 hypothetical patient summaries in an online task.

Official Title
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An Online International Comparison of Thresholds for Triggering a Negative Response to the Surprise Question

Conditions
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Palliative Care, Terminal Illness

Intervention / Treatment
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* Other: Online study


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Registered General Practitioner in one of the six participating countries Able to read and understand the language in which the questionnaire is presented to them Exclusion Criteria: None

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| General Practitioners<br>Registered General Practitioners in one of the six participating countries. | Other: Online study<br>* 20 hypothetical patient summaries<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Probability estimate | The continuous estimate of probability of dying within the next 12 months for the SQ (0-100%). | Participants will have up to 8 months (until the study closes) to provide an estimate for each vignette (n=20) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The Surprise Question | Dichotomous response to the SQ (Yes/No) | up to 8 months (until the study closes)Participants will have up to 8 months (until the study closes) to provide a response for each vignette (n=20) | 
| The alternative Surprise Question | Dichotomous response to the alternative SQ (Yes/No) | up to 8 months (until the study closes)Participants will have up to 8 months (until the study closes) to provide a response for each vignette (n=20) | 
| Treatment options | The options for the course of action selected by the participants in each vignette | up to 8 months (until the study closes)Participants will have up to 8 months (until the study closes) to provide a response for each vignette (n=20) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Surprise Question, Prognostication