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

Unity Health Toronto

Status: Completed

Conditions: Ischemic Stroke; Stroke; Cerebrovascular Disease

Treatments: Other: Clinical scenarios

Study type: Interventional

Funder types: Other

Identifiers

NCT01657279

09-020 (Other Identifier)

SMH 09-020

Details and patient eligibility

About

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.

Full 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

Enrollment: 111 patients

Sex: All

Ages: 20 to 75 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Practicing and active physicians managing patients with stroke

Exclusion criteria

• retired physicians
• physicians not exposed to care for stroke patients

Trial design

Primary purpose: Diagnostic

Allocation: N/A

Interventional model: Single Group Assignment

Masking: Double Blind

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111 participants in 1 patient group

Randomized clinical scenarios

Experimental group

Description:

Clinicians are randomized to a sequence of 5 clinical scenarios

Treatment:

Other: Clinical scenarios