Personalized Medicine Decision-Making in a Virtual Clinical Setting

Sponsor

National Human Genome Research Institute (NHGRI) (NIH)

Overall Status

Completed

CT.gov ID

NCT02108041

Collaborator

(none)

196

Enrollment

Locations

39.2

Patients Per Site

Study Details

Study Description

Brief Summary

Background:

-How people respond to drugs depends in part on their genes. For some drugs, doctors can use an individuals genetic background to help in dosing the drug. Researchers want to know how doctors incorporate personalized or genomic medicine into clinical practice.

Objective:

-To study how physicians make personalized treatment decisions

Eligibility:

-Healthy adult primary care physicians who are internal (or family) medicine residents.

Design:

Participants will complete a screening form.
Participants will put on a headset, called a head-mounted display, showing a virtual reality environment.
The environment will contain an exam room and the virtual patient.
After interacting with the virtual patient, participants will complete a series of survey measures.
Participation will last for about 60 minutes. The virtual patient interaction and follow-up questions will be audio taped.

Condition or Disease	Intervention/Treatment	Phase
Deep Vein Thrombosis Blood Clots

Detailed Description

This study will examine factors related to primary care physicians clinical decision-making. Using a virtual clinical interaction experiment, we aim to better understand physicians decision-making processes and to explore their communication behaviors toward patients in the clinical encounter. Physician participants will enter a virtual exam room where they will be asked to respond to a virtual patient, acting as her primary care physician in a follow-up visit to evaluate her for depression. Various aspects of physician communication in the virtual clinic and self-report measures related to decision-making will be analyzed.

Study Design

Study Type:

Observational

Actual Enrollment :

196 participants

Observational Model:

Case-Control

Time Perspective:

Cross-Sectional

Official Title:

Medical Decision-Making in a Virtual Clinical Setting

Actual Primary Completion Date :

Oct 8, 2020

Actual Study Completion Date :

Oct 8, 2020

Arms and Interventions

Arm	Intervention/Treatment
Physicians that interact with the black/High SES avatar patien Medical residents will then be randomized to be exposed to a virtual patient with one of 4 race/SES profiles, this one being a female patient who is Upper-Middle Income and Black/African American.
Physicians that interact with the black/Low SES avatar patient Medical residents will then be randomized to be exposed to a virtual patient with one of 4 race/SES profiles, this one being a female patient who is low-Middle Income and Black/African American.
Physicians that interact with the white race/high SES avatar Medical residents will then be randomized to be exposed to a virtual patient with one of 4 race/SES profiles, this one being a female patient who is Upper-Middle Income White andCaucasian.
Physicians that interact with the white race/low SES avatar p Medical residents will then be randomized to be exposed to a virtual patient with one of 4 race/SES profiles, this one being a female patient who is low Income White and Caucasian.

Outcome Measures

Primary Outcome Measures

To explore how physicians use genetic testing for anticoagulant (warfarin) dosage in patients of different racial/ethnic and SES backgrounds [Outcome measurements are assessed on the same date of the study visit.]
To explore how physicians use genetic testing for anticoagulant (warfarin) dosage in patients of different racial /ethnic and SES backgrounds

Eligibility Criteria

Criteria

Ages Eligible for Study:

21 Years and Older

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

INCLUSION CRITERIA:
All physicians will be healthy adult volunteers who are medical residents in the internal medicine specialty.

EXCLUSION CRITERIA:

persons with seizure or vestibular disorders;
persons who are highly prone to motion sickness;
those without normal or normal to corrected vision or hearing;
all current and past employees and contractors of NHGRI; and
persons who have received information about the study purpose or procedure from a past participant.

NHGRI employees are excluded for this protocol because they are likely to have specialized genomic knowledge and may think differently about genomics in the clinical interaction.

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Johns Hopkins School of Medicine	Baltimore	Maryland	United States	21205
2	Harvard School of Public Health	Boston	Massachusetts	United States	02115
3	Michigan State University	Flint	Michigan	United States
4	Columbia University	New York	New York	United States	10032-3784
5	University of Oregon	Eugene	Oregon	United States