Decision Aid for Parents of Infants With UPJO
Pilot-testing of a Decision Aid for Parents of Infants With Ureteropelvic Junction Obstruction (UPJO)
Ureteropelvic junction obstruction (UPJO) is the most common etiology of high-grade hydronephrosis, affecting approximately 4,000-10,000 infants annually in the U.S. The goal of surgical treatment of UPJO is to minimize the risk of kidney damage associated with obstruction, which may occur in 30-60% of infants with high-grade hydronephrosis.1-However, the benefit of early surgery compared to observation and potential later surgery to preserve kidney function has not been well-defined. Consequently, surgeons differ on whether to initially treat with surgery or observation, with surgical rates in the first year of life varying from 15-50% across surgical practices. These variations are important to understand, as the decision for early surgery is not without risk. Prior studies suggest that infants treated surgically are at higher risk for readmission and reoperation. Early surgery also raises concerns about neurodevelopmental effects of anesthetic exposure.
To address this gap, the purpose of this pilot test is to develop a patient decision aid (PtDA) tool and pilot test its effect on parental understanding and engagement in the decision-making process at Children's Hospital Colorado. The proposed pilot is a necessary first step in preparation for a future multicenter hybrid effectiveness-implementation trial. This work will also be used to support future studies evaluating the impact of a PtDA on surgical variations and treatment outcomes in patients with UPJO and other complex congenital urologic anomalies.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Alison Saville, MSPH, MSW
- Phone Number: 7202574406
- Email: alison.saville@cuanschutz.edu
Study Locations
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-
Colorado
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Aurora, Colorado, United States, 80045
- Recruiting
- Children's Hospital Colorado
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Contact:
- Vijaya Vemulakonda, MD, JD
- Phone Number: 720-777-4052
- Email: vijaya.vemulakonda@childrenscolorado.org
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Contact:
- Amelia Corl
- Email: AMELIA.CORL@CUANSCHUTZ.EDU
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Principal Investigator:
- Vijaya Vemulakonda, MD, JD
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-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria (all of following are needed):
- parents (age 18-89 years) of children age 30 days - 2 years
- child is presenting for consultation for SFU grade 3-4 Hydronephrosis at Children's Hospital Colorado
- parents/child presenting at Urology appointment where a MAG 3 is performed or has recently been performed.
Exclusion Criteria:
- does not meet age parameters
- does not have a child with a UPJO
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Health Services Research
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Experimental: Intervention Arm - Receipt of PtDA
Parents in the intervention arm will receive a paper decision aid prior to meeting with their health care professional about their child's treatment options for UPJO.
|
A paper parent decision aid in color will be provided to all patients at the time of their appointment and will aid in discussion with health care professionals.
|
|
No Intervention: Control - Usual Care
Parents in the control arm will not receive a paper decision aid and instead will just receive usual care about their child's treatment options for UPJO.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Differences in the SDM-Q9 scores between arms
Time Frame: through study completion, an average of 1 year
|
The primary outcome will be differences in scores between the 9-item Shared Decision Making Questionnaire (SDM-Q9) survey scores between intervention and control arms.
The SDM-Q9 is a validated survey instrument measuring patient understanding and engagement in the decision making process.
The scale for each question is 1-5 and higher scores mean better parent involvment and understanding.
|
through study completion, an average of 1 year
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Assess differences in treatment decisions
Time Frame: through study completion, an average of 1 year
|
The surgical rates of each patient will be assessed in each arm.
Demographic variables will be controlled for especially race, ethnicity, socioeconomic variables.
|
through study completion, an average of 1 year
|
Collaborators and Investigators
Sponsor
Sponsor
Collaborators
Collaborators
Investigators
Investigators
- Principal Investigator: Vijaya Vemulakonda, MD, JD, Children's Hospital Colorado
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
- Kidney Diseases
- Urologic Diseases
- Urogenital Abnormalities
- Congenital Abnormalities
- Ureteral Diseases
- Kidney Diseases, Cystic
- Female Urogenital Diseases
- Female Urogenital Diseases and Pregnancy Complications
- Urogenital Diseases
- Male Urogenital Diseases
- Ureteral Obstruction
- Multicystic Dysplastic Kidney
- Hydronephrosis
Other Study ID Numbers
Other Study ID Numbers
- 23-0037
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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