Effect of Videogames on Real-life Triage Patterns

Study Overview
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Brief Summary
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In 2016 and 2017 the investigators conducted two clinical trials in which emergency medicine physicians were randomized either to an intervention (customized, theoretically-based video games) or to a control (nothing or text-based education). This study will now assess long-term outcomes for physicians enrolled in those two trials to evaluate the effect of the interventions on triage practices for trauma patients who presented initially to non-trauma centers in the US between December 2016 and November 2018.

Official Title
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Long-term Followup of Effects of Customized Videogames on Physician Triage Practices

Conditions
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Trauma, Physician's Role

Intervention / Treatment
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* Behavioral: Video games


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participated in two prior clinical trials (Physician) ≥65 years old (Patient) enrolled in Medicare fee-for-service sustained a moderate-severe injury (i.e. ISS [injury severity score] >15) (Patient) treated by physician enrolled in prior clinical trials (Patient) Exclusion Criteria: Did not participate in two prior clinical trials (Physician) <65 years old (Patient)

Ages Eligible for Study
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Minimum Age: 25 Years
Maximum Age: 100 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Video game<br>Patients treated by physicians who were randomized to either play an adventure-based video game that used narrative engagement to recalibrate physician heuristics in trauma triage or a puzzle-based video game that used analogical encoding to recalibrate physician heuristics in trauma triage. | Behavioral: Video games<br>* See arm description<br>|
| Control<br>Patients treated by physicians who were randomized either to nothing at all or to a text-based educational program. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of patients triaged to trauma centers | The investigators will use Medicare claims to measure the number of patients, treated by study participants, who present initially to non-trauma centers after a moderate-severe injury and are transferred to a Level I/II trauma center during that episode of care. They will compare triage patterns for patients treated by physicians in the intervention and in the control groups. | 1 year following the intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Number of moderate-severely injured patients who die 30-days after initial evaluation | Patient mortality 30-days after evaluation for a moderate-severe injury by a physician enrolled in the trial, compared among intervention and control groups. | 1 year following the intervention | 
| Frequency of resources used for patients with moderate-severe injuries treated by participants | Frequency of resources used (e.g. ICU admission, mechanical ventilation, disposition status) after initial presentation for a moderate-severe injury and treatment by a participating physician, compared among intervention and control groups. | 1 year following intervention |