Personalized Medicine Decision-Making in a Virtual Clinical Setting

NCT02108041 | Completed

• 2 other identifiers: 99991407514-HG-N075
• Study Type: observational
• Target: 196
• Locations: 1 country
• Sites: 5

Brief Summary

Background:

• How people respond to drugs depends in part on their genes. For some drugs, doctors can use an individuals genetic background to help in dosing the drug. Researchers want to know how doctors incorporate personalized or genomic medicine into clinical practice. Objective:
• To study how physicians make personalized treatment decisions Eligibility:
• Healthy adult primary care physicians who are internal (or family) medicine residents. Design:
• Participants will complete a screening form.
• Participants will put on a headset, called a head-mounted display, showing a virtual reality environment.
• The environment will contain an exam room and the virtual patient.
• After interacting with the virtual patient, participants will complete a series of survey measures.
• Participation will last for about 60 minutes. The virtual patient interaction and follow-up questions will be audio taped.

Conditions

Blood Clots; Deep Vein Thrombosis

Keywords

Physicians; Genomics; Internal Medicine; Warfarin; Natural History

Outcome Measures

Primary Outcomes (1)

• To explore how physicians use genetic testing for anticoagulant (warfarin) dosage in patients of different racial/ethnic and SES backgrounds

  To explore how physicians use genetic testing for anticoagulant (warfarin) dosage in patients of different racial /ethnic and SES backgrounds

  Outcome measurements are assessed on the same date of the study visit.

Study Arms (4)

Physicians that interact with the black/High SES avatar patien

Medical residents will then be randomized to be exposed to a virtual patient with one of 4 race/SES profiles, this one being a female patient who is Upper-Middle Income and Black/African American.

Physicians that interact with the black/Low SES avatar patient

Medical residents will then be randomized to be exposed to a virtual patient with one of 4 race/SES profiles, this one being a female patient who is low-Middle Income and Black/African American.

Physicians that interact with the white race/high SES avatar

Medical residents will then be randomized to be exposed to a virtual patient with one of 4 race/SES profiles, this one being a female patient who is Upper-Middle Income White andCaucasian.

Physicians that interact with the white race/low SES avatar p

Medical residents will then be randomized to be exposed to a virtual patient with one of 4 race/SES profiles, this one being a female patient who is low Income White and Caucasian.

Eligibility Criteria

• Age: 21 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

Internal medicine and family medicine residents will be recruited from diverse national sites for the study, and the virtual reality environment will be brought to them through the use of a head-mounted display and laptop

You may qualify if:

• All physicians will be healthy adult volunteers who are medical residents in the internal medicine specialty.

You may not qualify if:

• persons with seizure or vestibular disorders;
• persons who are highly prone to motion sickness;
• those without normal or normal to corrected vision or hearing;
• all current and past employees and contractors of NHGRI; and
• persons who have received information about the study purpose or procedure from a past participant.
• NHGRI employees are excluded for this protocol because they are likely to have specialized genomic knowledge and may think differently about genomics in the clinical interaction.

Sponsors & Collaborators

• National Human Genome Research Institute (NHGRI): lead

Study Sites (5)

Johns Hopkins School of Medicine

Baltimore, Maryland, 21205, United States

Location

Harvard School of Public Health

Boston, Massachusetts, 02115, United States

Location

Michigan State University

Flint, Michigan, United States

Location

Columbia University

New York, New York, 10032-3784, United States

Location

University of Oregon

Eugene, Oregon, United States

Location

Related Publications (2)

• Green AR, Carney DR, Pallin DJ, Ngo LH, Raymond KL, Iezzoni LI, Banaji MR. Implicit bias among physicians and its prediction of thrombolysis decisions for black and white patients. J Gen Intern Med. 2007 Sep;22(9):1231-8. doi: 10.1007/s11606-007-0258-5. Epub 2007 Jun 27.

  PMID: 17594129 BACKGROUND

• Armstrong K. Genomics and health care disparities: the role of statistical discrimination. JAMA. 2012 Nov 21;308(19):1979-80. doi: 10.1001/2012.jama.10820. No abstract available.

  PMID: 23138130 BACKGROUND

MeSH Terms

Conditions

Venous Thrombosis; Thrombosis

Condition Hierarchy (Ancestors)

Embolism and Thrombosis; Vascular Diseases; Cardiovascular Diseases

Study Officials

• Susan J Persky, Ph.D.

  National Human Genome Research Institute (NHGRI)

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: NIH
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 5, 2014
• First Posted: April 9, 2014
• Primary Completion: October 8, 2020
• Study Completion: October 8, 2020
• Last Updated: April 24, 2026

Record last verified: 2025-10-17

Data Sharing

• IPD Sharing: Will not share

Locations

US (5)