دورية أكاديمية
Impact of a machine learning algorithm on time to palliative care in a primary care population: protocol for a stepped-wedge pragmatic randomized trial.
| العنوان: | Impact of a machine learning algorithm on time to palliative care in a primary care population: protocol for a stepped-wedge pragmatic randomized trial. |
|---|---|
| المؤلفون: | Heinzen EP; Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA. heinzen.ethan@mayo.edu., Wilson PM; Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA., Storlie CB; Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA., Demuth GO; Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA., Asai SW; Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA., Schaeferle GM; Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA., Bartley MM; Community Internal Medicine, Mayo Clinic, Rochester, MN, USA., Havyer RD; Community Internal Medicine, Mayo Clinic, Rochester, MN, USA. |
| المصدر: | BMC palliative care [BMC Palliat Care] 2023 Feb 03; Vol. 22 (1), pp. 9. Date of Electronic Publication: 2023 Feb 03. |
| نوع المنشور: | Clinical Trial Protocol; Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: BioMed Central Country of Publication: England NLM ID: 101088685 Publication Model: Electronic Cited Medium: Internet ISSN: 1472-684X (Electronic) Linking ISSN: 1472684X NLM ISO Abbreviation: BMC Palliat Care Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: London : BioMed Central, [2002- |
| مواضيع طبية MeSH: | Hospice and Palliative Care Nursing* , Palliative Care*/methods, Humans ; Patients ; Primary Health Care ; Quality of Life ; Randomized Controlled Trials as Topic ; Pragmatic Clinical Trials as Topic |
| مستخلص: | Background: As primary care populations age, timely identification of palliative care need is becoming increasingly relevant. Previous studies have targeted particular patient populations with life-limiting disease, but few have focused on patients in a primary care setting. Toward this end, we propose a stepped-wedge pragmatic randomized trial whereby a machine learning algorithm identifies patients empaneled to primary care units at Mayo Clinic (Rochester, Minnesota, United States) with high likelihood of palliative care need. Methods: 42 care team units in 9 clusters were randomized to 7 wedges, each lasting 42 days. For care teams in treatment wedges, palliative care specialists review identified patients, making recommendations to primary care providers when appropriate. Care teams in control wedges receive palliative care under the standard of care. Discussion: This pragmatic trial therefore integrates machine learning into clinical decision making, instead of simply reporting theoretical predictive performance. Such integration has the possibility to decrease time to palliative care, improving patient quality of life and symptom burden. Trial Registration: Clinicaltrials.gov NCT04604457 , restrospectively registered 10/26/2020. Protocol: v0.5, dated 9/23/2020. (© 2023. The Author(s).) |
| References: | J Palliat Med. 2019 Sep;22(S1):58-65. (PMID: 31486727) Stat Methods Med Res. 2013 Jun;22(3):324-45. (PMID: 22491174) Cancers (Basel). 2020 May 03;12(5):. (PMID: 32375249) Crit Care Med. 2019 Dec;47(12):1707-1715. (PMID: 31609772) Lancet Oncol. 2018 Mar;19(3):394-404. (PMID: 29402701) N Engl J Med. 2010 Aug 19;363(8):733-42. (PMID: 20818875) Lancet. 2014 May 17;383(9930):1721-30. (PMID: 24559581) J Clin Oncol. 2012 Dec 10;30(35):4380-6. (PMID: 23109708) CMAJ. 2016 Jul 12;188(10):E217-E227. (PMID: 27091801) J Clin Oncol. 2017 Mar 10;35(8):834-841. (PMID: 28029308) J Gen Intern Med. 2019 Sep;34(9):1841-1847. (PMID: 31313110) |
| معلومات مُعتمدة: | NA: internal funding Mayo Clinic Robert D and Patricia E Kern Center for the Science of Healthcare Delivery |
| فهرسة مساهمة: | Keywords: Machine learning; Protocol; Randomized trial |
| سلسلة جزيئية: | ClinicalTrials.gov NCT04604457 |
| تواريخ الأحداث: | Date Created: 20230204 Date Completed: 20230209 Latest Revision: 20230209 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC9896817 |
| DOI: | 10.1186/s12904-022-01113-0 |
| PMID: | 36737744 |
| قاعدة البيانات: | MEDLINE |
Find this article in full text from Springer Verlag. 
Full Text Finder | تدمد: | 1472-684X |
|---|---|
| DOI: | 10.1186/s12904-022-01113-0 |