The Effect of Peer Comparison Emails on Oncologists' Documentation of Cancer Stage

NCT04298762 | Completed

• 1 other identifier: staging_documentation
• Study Type: interventional
• Target: 56
• Locations: 1 country
• Sites: 1

Brief Summary

Documenting cancer stage is the most important determinant of treatment approach and survival for cancer patients. However, oncologists do not routinely document a patient's cancer stage in the structured field in electronic health records. This quality improvement pilot study evaluated the impact of sending an email to physicians at a cancer center of a large academic hospital with individualized data on their rates of cancer stage documentation using a structured field. The investigators assessed patient-level documentation and physician-level rates of staging documentation over 15 months including a three-month pre-period, a six-month pilot phase and a six-month follow-up period. The investigators also estimated staging documentation rates separately for each physician's new versus established patients.

Conditions

Oncology

Outcome Measures

Primary Outcomes (1)

• Measuring if a patient's cancer stage was documented in a structured field in the Electronic Health Record on the date of the patient's first ambulatory care visit

  Indicator of whether the structured field for cancer stage in the patient's electronic health record (EHR) was populated on the date of the first outpatient encounter that a patient had during the study period (1=yes, 0=no)

  15 months

Secondary Outcomes (1)

• Staging documentation rate (monthly)

  15 months

Study Arms (2)

Comparison Group

PLACEBO COMPARATOR

Physicians in the control group did not receive peer comparison emails.

Other: No peer comparison email

Intervention Group

EXPERIMENTAL

Physicians in the intervention group received peer comparison emails.

Other: Peer comparison email

Interventions

No peer comparison email OTHER

The comparison group received no email communication on their cancer stage documentation activity.

Comparison Group

Peer comparison email OTHER

The intervention group received three separate emails with individualized data on their cancer stage documentation activity in the previous 1-3 months. The email described the number and percent of attributed patients for whom cancer stage was documented, and included a figure showing their staging documentation rate compared to their peers.

Intervention Group

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Attending physicians who had been at one of three sites of hospital between January - August 2018

You may not qualify if:

• Physicians treating cancer patients where American Joint Committee on Cancer (AJCC) staging modules were less clinically relevant
• Physicians with low clinical volume (\<5 patients over 3 months)
• Physicians without any outpatient visits

Sponsors & Collaborators

• Harvard School of Public Health (HSPH): lead
• Massachusetts General Hospital: collaborator

Study Sites (1)

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

Location

MeSH Terms

Conditions

Neoplasms

Study Officials

• Anna Sinaiko, PhD

  Harvard School of Public Health (HSPH)

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Assistant Professor of Health Economics and Policy

Study Record Dates

• First Submitted: February 11, 2020
• First Posted: March 6, 2020
• Study Start: July 1, 2018
• Primary Completion: September 30, 2019
• Study Completion: September 30, 2019
• Last Updated: March 6, 2020

Record last verified: 2020-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)