Clinical trial NCT03697213: The Surprise Study
Official title: An Online International Comparison of Thresholds for Triggering a Negative Response to the "Surprise Question"
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Palliative Care
Terminal Illness
Keywords: Surprise Question
Prognostication
Lead sponsor: University College, London
Sponsor class: OTHER
Collaborators: name: Johannes Gutenberg University Mainz
name: Radboud University Medical Center
name: University of Bern
name: Imperial College London
name: Universiteit Antwerpen
name: University of Bologna
First posted: 2018-10-05
Enrollment: 250
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: yes
Observational model: COHORT
Time perspective: CROSS_SECTIONAL
Sampling method: NON_PROBABILITY_SAMPLE
Study population: A convenience sample of registered General Practitioners (GPs) with a variety of years of experience and seniority across six European countries will be approached to participate

Brief summary: 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: 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.

Eligibility criteria: 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

Primary outcomes:
measure: Probability estimate
timeFrame: Participants will have up to 8 months (until the study closes) to provide an estimate for each vignette (n=20)
Secondary outcomes:
measure: The Surprise Question
timeFrame: 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)
measure: The alternative Surprise Question
timeFrame: 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)
measure: Treatment options
timeFrame: 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)
Other outcomes:
Locations:
city: Antwerp
country: Belgium
facility: University of Antwerp
city: Mainz
country: Germany
facility: University of Mainz
city: Bologna
country: Italy
facility: University of Bologna
city: Nijmegen
country: Netherlands
facility: Radboud University Medical Centre
city: Bern
country: Switzerland
facility: University Hospital of Bern
city: London
country: United Kingdom
facility: Marie Curie Palliative Care Research Department
Study officials:
affiliation: University College, London
name: Patrick Stone, MA, MD, FRCP
role: PRINCIPAL_INVESTIGATOR
References:
citation: White N, Oostendorp LJ, Vickerstaff V, Gerlach C, Engels Y, Maessen M, Tomlinson C, Wens J, Leysen B, Biasco G, Zambrano S, Eychmuller S, Avgerinou C, Chattat R, Ottoboni G, Veldhoven C, Stone P. An online international comparison of palliative care identification in primary care using the Surprise Question. Palliat Med. 2022 Jan;36(1):142-151. doi: 10.1177/02692163211048340. Epub 2021 Oct 1.
citation: White N, Oostendorp L, Vickerstaff V, Gerlach C, Engels Y, Maessen M, Tomlinson C, Wens J, Leysen B, Biasco G, Zambrano S, Eychmuller S, Avgerinou C, Chattat R, Ottoboni G, Veldhoven C, Stone P. An online international comparison of thresholds for triggering a negative response to the "Surprise Question": a study protocol. BMC Palliat Care. 2019 Apr 9;18(1):36. doi: 10.1186/s12904-019-0413-x.