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

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ClinicalTrials.gov Identifier: NCT04298762
Recruitment Status : Completed
First Posted : March 6, 2020
Last Update Posted : March 6, 2020
Sponsor:
Collaborator:
Massachusetts General Hospital
Information provided by (Responsible Party):
Anna Sinaiko, Harvard School of Public Health (HSPH)

Study Description
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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.

Condition or disease Intervention/treatment Phase
Oncology Other: No peer comparison email Other: Peer comparison email Not Applicable

Study Design
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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 56 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Single (Participant)
Primary Purpose: Health Services Research
Official Title: The Effect of Peer Comparison Emails on Oncologists' Documentation of Cancer Stage
Actual Study Start Date : July 1, 2018
Actual Primary Completion Date : September 30, 2019
Actual Study Completion Date : September 30, 2019
Arms and Interventions
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Arm Intervention/treatment
Placebo Comparator: Comparison Group
Physicians in the control group did not receive peer comparison emails.
 Other: No peer comparison email
The comparison group received no email communication on their cancer stage documentation activity.
Experimental: Intervention Group
Physicians in the intervention group received peer comparison emails.
 Other: Peer comparison email
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.


Outcome Measures
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Primary Outcome Measures :
  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 [ Time Frame: 15 months ]
    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)


Secondary Outcome Measures :
  1. Staging documentation rate (monthly) [ Time Frame: 15 months ]
    Percentage of patients whose first outpatient encounter occurred in a given month for whom cancer stage was documented


Eligibility Criteria
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Ages Eligible for Study:   Child, Adult, Older Adult
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Criteria

Inclusion Criteria:

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

Exclusion Criteria:

  • 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
Contacts and Locations
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Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its ClinicalTrials.gov identifier (NCT number): NCT04298762


Locations
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United States, Massachusetts
Massachusetts General Hospital
Boston, Massachusetts, United States, 02114
Sponsors and Collaborators
Harvard School of Public Health (HSPH)
Massachusetts General Hospital
Investigators
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Principal Investigator: Anna Sinaiko, PhD Harvard School of Public Health (HSPH)
More Information
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Responsible Party: Anna Sinaiko, Assistant Professor of Health Economics and Policy, Harvard School of Public Health (HSPH)
ClinicalTrials.gov Identifier: NCT04298762    
Other Study ID Numbers: staging_documentation
First Posted: March 6, 2020    Key Record Dates
Last Update Posted: March 6, 2020
Last Verified: March 2020
Individual Participant Data (IPD) Sharing Statement:
Plan to Share IPD: No

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Studies a U.S. FDA-regulated Drug Product: No
Studies a U.S. FDA-regulated Device Product: No
Additional relevant MeSH terms:
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Neoplasms