Clinician JUdgment Versus Risk Score to Predict Stroke outComes: The JURASSIC Clinical Trial "JURASSIC"

Completed

Phase N/A Results N/A

Trial Description

Background: Several risk score models are now available to assist clinicians estimate outcomes after an acute ischemic stroke. Limited information is available on the predictive value of these scores compared to real outcomes and clinical judgment.
Objectives: To compare clinician judgment with the use of a validated stroke risk score (iScore) and patients' outcomes.

Detailed Description

A convenience sample of 111 practicing clinicians (general and vascular neurologists, internists, and ER physicians) predicted the outcomes of 5 stroke patients based on case summaries. Cases were randomly selected as being representative of the 10 most common clinical scenarios (n=1,415) from a pool of over 12,000 patients admitted to stroke centers in Ontario, Canada. Stroke cases had known clinical presentation, comorbidities, stroke severity, and outcomes.
All participants are active practicing physicians caring for patients with acute stroke. Conditions were standardized to mimic clinical practice.
Main outcomes of interest included 30-day mortality and death or disability at discharge.
Secondary outcome: death or institutionalization at discharge

Conditions

Interventions

  • Clinical scenarios Other
    Intervention Desc: Clinicians will be randomized to a sequence of 5 clinical scenarios with a variable range of expected outcome [i.e. from low (<10%) to high (>50%) expected risk death at 30 days].
    ARM 1: Kind: Experimental
    Label: Randomized clinical scenarios
    Description: Clinicians are randomized to a sequence of 5 clinical scenarios

Trial Design

  • Masking: Double Blind (Investigator, Outcomes Assessor)
  • Purpose: Diagnostic
  • Endpoint: Efficacy Study
  • Intervention: Single Group Assignment

Outcomes

Type Measure Time Frame Safety Issue
Primary Death or disability (mRS >3) at discharge up to 30 days after discharge No
Secondary Death at 30 days 30 days No
Secondary Death or institutionalization at discharge up to 30 days after discharge No
Primary 30 Day Mortality or Disability (mRS >3) at discharge Death after 30 days from ischemic stroke onset or Disability following hospital discharge No

Sponsors