- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04044469
Reappraisal Of Medical Assurance (ROMA): An Experimental Study in Patients With Functional Somatic Symptoms (ROMA)
Why Medical Reassurance Fails in Patients With Functional Somatic Symptoms - An Experimental Study on Cognitive Immunization
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
It is known from research on functional somatic symptoms that patients continue to worry about having a serious illness despite receiving medical reassurance and normal medical test results. However, the psychological mechanisms underlying this maintenance of concern are largely unknown. The planned study will therefore apply knowledge from depression research to this question: In the field of depression there is sound evidence that people with depressive symptoms maintain negative expectations despite positive experiences to the contrary, and in previous work it was shown that this is due to a cognitive re-appraisal of expectation-disconfirming experiences, referred to as cognitive immunization. The planned study seeks to investigate whether cognitive immunization is also a mechanism underlying sustained concerns about having a serious disease despite medical reassurance in patients with functional somatic symptoms. For this purpose, participants are presented with a vignette in which gastrointestinal complaints are reported; participants are instructed to imagine to suffer from these symptoms and to go a doctor to have their symptoms examined. Subsequently, participants watch a videotaped doctor's report in which a family doctor discusses the results of several medical tests that have been carried out to exclude the possibility of some serious diseases, such as colon cancer. In this report, the doctor states clearly that, based on the test results, a serious disease is very unlikely. Afterwards, participants of some experimental groups receive additional information on the accuracy of medical diagnostics, aimed at differentially varying the appraisal of the medical reassurance received.
The experimental conditions described above apply only to the sample of patients with functional somatic symptoms (inclusion and exclusion criteria see below). In addition, we will also recruit a clinical (patients with depression, n=30) and healthy control group (n=30). These control groups will not undergo the cognitive immunization manipulation, but will only pass through the basic procedure of the experimental paradigm, that is, the same procedure as the control group from the sample of patients with functional somatic symptoms. These two control groups (healthy and clinical) are recruited to replicate previous findings showing that patients with somatic symptoms report increased probabilities of suffering from a serious disease compared to patients with depression and healthy control participants. Below, we will only present the inclusion and exclusion criteria of the sample with functional somatic symptoms.
Study Type
Enrollment (Actual)
Phase
- Not Applicable
Contacts and Locations
Study Locations
-
-
Rheinland-Pfalz
-
Landau, Rheinland-Pfalz, Germany, 76829
- University of Koblenz-Landau
-
-
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Primary diagnosis of a somatoform disorder (F45.x) (as assessed with the SKID interview)
- Age between 18 and 69
- Sufficient German language skills
Exclusion Criteria:
- acute life-threatening disease
- diagnosed mental disorder other than the somatoform disorder that is considered the primary diagnosis (people with other comorbid mental disorders are not excluded if the somatoform disorder is the primary diagnosis)
Study Plan
How is the study designed?
Design Details
- Primary Purpose: BASIC_SCIENCE
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
EXPERIMENTAL: Immunization-enhancement
This group receives an immunization-promoting manipulation aimed at triggering negative appraisals of the medical information received and questioning the validity of the medical reassurance.
For this purpose, a standardized information text is presented to the participants after receipt of the doctor's report, in which it is stated that the standard medical diagnosis in gastroenterology is often not particularly accurate and that serious diseases are from times to times overlooked.
As a further factor contributing to the non-detection of diseases, it is mentioned that doctors are often under time pressure and thus do not have sufficient time to ask patients for all important information.
It is believed that communicating this information will result in participants continuing to report high probabilities of serious illness despite the previously received findings report.
|
This group receives a standardized information text, suggesting that medical diagnostics is not very accurate.
Reasons for why a serious disease is overlooked are mentioned and discussed.
|
EXPERIMENTAL: Immunization-inhibition
The aim of the immunization-inhibiting manipulation is to increase the probability that the normal test results obtained will be used to reduce worries about a serious illness.
The participants of this group receive - analogous to the immunization-promoting group - a standardized information text which states that the standard medical diagnosis in gastroenterology is very accurate and that the physicians are very often correct in their initial diagnostic assessment, especially with regard to the assessment of a serious organic disease.
This is supported by two scientific publications.
The aim of this information is to increase the value of the results obtained, so that the participants are more reassured as a result of the inconspicuous test results and use them to correct their health-related concerns.
|
This group receives a standardized information text, suggesting that medical diagnostics is very accurate and that doctors are very often right in their first initial diagnostic assessments.
|
EXPERIMENTAL: Control group
This group does not receive additional information after the doctor's report.
|
This group receives no further information after watching the videotaped doctor's report.
|
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Likelihood of a serious disease scale
Time Frame: 2 minutes after the doctor's report
|
Numerical analogue scale to assess the likelihood of having a serious disease (0 = serious disease excluded; 100 = serious disease for sure)
|
2 minutes after the doctor's report
|
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Cognitive immunization against medical reassurance scale
Time Frame: 5 minutes after the doctor's report
|
Assessment of cognitive reappraisal of medical reassurance; each item is scored 1-7 (1 = totally disagree; 7 = totally agree)
|
5 minutes after the doctor's report
|
Collaborators and Investigators
Investigators
- Principal Investigator: Tobias Kube, PhD, University of Kaiserslautern-Landau
Study record dates
Study Major Dates
Study Start (ACTUAL)
Primary Completion (ACTUAL)
Study Completion (ACTUAL)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (ACTUAL)
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- ROMA_199
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
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.
Clinical Trials on Somatic Symptom Disorder
-
Daniel MarotiWayne State UniversityRecruitingSomatic Symptom Disorder | Functional Somatic Disorder | Functional Somatic SyndromesSweden
-
Karolinska InstitutetCompletedSomatic Symptom DisorderSweden
-
Karolinska InstitutetStockholm UniversityCompletedSomatic Symptom DisorderSweden
-
Daniel MarotiWayne State UniversityActive, not recruitingSomatic Symptom Disorder | Functional Somatic DisorderSweden
-
Karolinska InstitutetRegion StockholmCompletedIllness Anxiety Disorder | Somatic Symptom DisorderSweden
-
IRCCS Burlo GarofoloCompletedSomatic Symptom DisorderItaly
-
National Taiwan University HospitalRecruitingSomatic Symptom DisorderTaiwan
-
National Taiwan University HospitalRecruitingSomatic Symptom DisorderTaiwan
-
National Taiwan University HospitalNational Taiwan University Hospital, Yun-Lin BranchRecruitingSomatoform Disorders | Somatic Symptom DisorderTaiwan
-
Philipps University Marburg Medical CenterUnknownSomatic Symptom Disorder (DSM-5)Germany
Clinical Trials on Immunization-enhancement
-
Auburn UniversityMerck Sharp & Dohme LLC; Keck Graduate Institute of Claremont, CaliforniaCompletedPneumococcal Infections | Herpes ZosterUnited States
-
Assistance Publique - Hôpitaux de ParisInstitut National de la Santé Et de la Recherche Médicale, FranceRecruitingCOVID | Psychiatric DisordersFrance
-
GlaxoSmithKlineCompletedTetanus | Diphtheria | Acellular Pertussis | Diphtheria-Tetanus-acellular Pertussis Vaccines | Aspergillosis, Allergic BronchopulmonaryColombia
-
Columbia UniversitySeattle Children's Hospital; New York Presbyterian Hospital; Agency for Healthcare...Completed
-
University of Colorado, DenverNational Institute of Allergy and Infectious Diseases (NIAID)CompletedMaternal ImmunizationUnited States
-
U.S. Army Medical Research and Development CommandBill and Melinda Gates Foundation; Seattle Children's Research Institute (SCRI)Completed
-
University of Colorado, DenverAgency for Healthcare Research and Quality (AHRQ)RecruitingTransplantation Infection | VaccinationUnited States
-
JhpiegoGavi, The Vaccine AllianceNot yet recruitingGender Equality and Its Impact on Immunization Uptake
-
Auburn UniversityAgency for Healthcare Research and Quality (AHRQ)CompletedImmunizationUnited States
-
University of Alabama at BirminghamCompletedChildhood Immunization Completion | Childhood Immunization Dropout | Immunization Card | Center Based EducationPakistan