Evidence map›Paper›PMID 30979361›Full record

ArticleBMC palliative care2019

An online international comparison of thresholds for triggering a negative response to the "Surprise Question": a study protocol.

Nicola White, Linda Oostendorp, Victoria Vickerstaff, Christina Gerlach, Yvonne Engels, Maud Maessen, Christopher Tomlinson, Johan Wens, Bert Leysen, Guido Biasco and 7 more

Erratum issued Registry-linked trialAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC palliative care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT03697213 (An Online International Comparison of Thresholds for Triggering a Negative Response to the "Surprise Question"), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03697213 completednot on this map

An Online International Comparison of Thresholds for Triggering a Negative Response to the "Surprise Question"

TypeobservationalSponsorUniversity College, LondonRan2019 to 2020Enrolled250ConditionsPalliative Care, Terminal IllnessArmsOnline study
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors.

Nicola WhiteUniversity College London, London, UK. n.g.white@ucl.ac.uk.ORCID http://orcid.org/0000-0002-7438-0072
Linda OostendorpUniversity College London, London, UK.
Victoria VickerstaffUniversity College London, London, UK.
Christina GerlachUniversity of Mainz, Mainz, Germany.
Yvonne EngelsRadboud University Medical Centre, Nijmegen, The Netherlands.
Maud MaessenUniversity Hospital of Bern, Bern, Switzerland.
Christopher TomlinsonImperial College London, London, UK.
Johan WensUniversity of Antwerp, Antwerp, Belgium.
Bert LeysenUniversity of Antwerp, Antwerp, Belgium.
Guido BiascoUniversity of Bologna & Academy of the Sciences of Palliative Medicine, Bologna, Italy.
Sofia ZambranoUniversity Hospital of Bern, Bern, Switzerland.
Steffen EychmüllerUniversity Hospital of Bern, Bern, Switzerland.
Christina AvgerinouUniversity College London, London, UK.
Rabih ChattatUniversity of Bologna, Bologna, Italy.
Giovanni OttoboniUniversity of Bologna, Bologna, Italy.
Carel VeldhovenRadboud University Medical Centre, Nijmegen, The Netherlands.
Patrick StoneUniversity College London, London, UK.

Funding

Marie Curie MCCC-FCH-18-UMarie Curie MCCC-FCO-11-UMarie Curie MCCC-FPO-16-UMarie Curie Cancer Care MCCC-FPO-18-U
6 · The paper itself

Abstract

backgroundThe Surprise Question (SQ) "would I be surprised if this patient were to die in the next 12 months?" has been suggested to help clinicians, and especially General Practitioners (GPs), identify people who might benefit from palliative care. The prognostic accuracy of this approach is unclear and little is known about how GPs use this tool in practice. Are GPs consistent, individually and as a group? Are there international differences in the use of the tool? Does including the alternative Surprise Question ("Would I be surprised if the patient were still alive after 12 months?") alter the response? What is the impact on the treatment plan in response to the SQ? This study aims to address these questions.

methodsAn online study will be completed by 600 (100 per country) registered GPs. They will be asked to review 20 hypothetical patient vignettes. For each vignette they will be asked to provide a response to the following four questions: (1) the SQ [Yes/No]; (2) the alternative SQ [Yes/No]; (3) the percentage probability of dying [0% no chance - 100% certain death]; and (4) the proposed treatment plan [multiple choice]. A "surprise threshold" for each participant will be calculated by comparing the responses to the SQ with the probability estimates of death. We will use linear regression to explore any differences in thresholds between countries and other clinician-related factors, such as years of experience. We will describe the actions taken by the clinicians and explore the differences between groups. We will also investigate the relationship between the alternative SQ and the other responses. Participants will receive a certificate of completion and the option to receive feedback on their performance. DISCUSSION: This study explores the extent to which the SQ is consistently used at an individual, group, and national level. The findings of this study will help to understand the clinical value of using the SQ in routine practice.

trial registrationClinicaltrials.gov NCT03697213 (05/10/2018). Prospectively registered.

Indexed as

Attitude of Health PersonnelAttitude to DeathPrognosisBelgiumGeneral PractitionersGermanyHumansInternetItalyNetherlandsPalliative CareSurveys and QuestionnairesSwitzerlandUnited KingdomDeathPalliative carePrognosisSurprise questionSurvival

Identifiers

PMID30979361
PMCPMC6461816

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.