Effect of Videogames on Real-life Triage Patterns

Long-term Followup of Effects of Customized Videogames on Physician Triage Practices

In 2016 and 2017 the investigators conducted two clinical trials in which emergency medicine physicians were randomized either to an intervention (customized, theoretically-based video games) or to a control (nothing or text-based education). This study will now assess long-term outcomes for physicians enrolled in those two trials to evaluate the effect of the interventions on triage practices for trauma patients who presented initially to non-trauma centers in the US between December 2016 and November 2018.

Study Overview

• Status: Completed
• Conditions: Trauma; Physician's Role
• Intervention / Treatment: Behavioral: Video games

• Study Type: Observational
• Enrollment (Actual): 686

Contacts and Locations

Study Locations

• United States
  • Pennsylvania
    • Pittsburgh, Pennsylvania, United States, 15213
      • University of Pittsburgh

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 25 years to 100 years (ADULT, OLDER_ADULT)
• Accepts Healthy Volunteers: N/A
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

Patients older than 65 who presented after a moderate-severe injury to a non-trauma center in the US during 2016-2018.

Description

Inclusion Criteria:

• Participated in two prior clinical trials (Physician)
• ≥65 years old (Patient)
• enrolled in Medicare fee-for-service
• sustained a moderate-severe injury (i.e. ISS [injury severity score] >15) (Patient)
• treated by physician enrolled in prior clinical trials (Patient)

Exclusion Criteria:

• Did not participate in two prior clinical trials (Physician)
• <65 years old (Patient)

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Video game; Patients treated by physicians who were randomized to either play an adventure-based video game that used narrative engagement to recalibrate physician heuristics in trauma triage or a puzzle-based video game that used analogical encoding to recalibrate physician heuristics in trauma triage.	Behavioral: Video games; See arm description
Control; Patients treated by physicians who were randomized either to nothing at all or to a text-based educational program.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of patients triaged to trauma centers	The investigators will use Medicare claims to measure the number of patients, treated by study participants, who present initially to non-trauma centers after a moderate-severe injury and are transferred to a Level I/II trauma center during that episode of care. They will compare triage patterns for patients treated by physicians in the intervention and in the control groups.	1 year following the intervention

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of moderate-severely injured patients who die 30-days after initial evaluation	Patient mortality 30-days after evaluation for a moderate-severe injury by a physician enrolled in the trial, compared among intervention and control groups.	1 year following the intervention
Frequency of resources used for patients with moderate-severe injuries treated by participants	Frequency of resources used (e.g. ICU admission, mechanical ventilation, disposition status) after initial presentation for a moderate-severe injury and treatment by a participating physician, compared among intervention and control groups.	1 year following intervention

Collaborators and Investigators

• Sponsor: University of Pittsburgh
• Collaborators: National Library of Medicine (NLM)

Publications and helpful links

General Publications

• Mohan D, Farris C, Fischhoff B, Rosengart MR, Angus DC, Yealy DM, Wallace DJ, Barnato AE. Efficacy of educational video game versus traditional educational apps at improving physician decision making in trauma triage: randomized controlled trial. BMJ. 2017 Dec 12;359:j5416. doi: 10.1136/bmj.j5416.
• Mohan D, Fischhoff B, Angus DC, Rosengart MR, Wallace DJ, Yealy DM, Farris C, Chang CH, Kerti S, Barnato AE. Serious games may improve physician heuristics in trauma triage. Proc Natl Acad Sci U S A. 2018 Sep 11;115(37):9204-9209. doi: 10.1073/pnas.1805450115. Epub 2018 Aug 27.

Study record dates

Study Major Dates

• Study Start (ACTUAL): October 30, 2016
• Primary Completion (ACTUAL): December 1, 2018
• Study Completion (ACTUAL): December 1, 2020

Study Registration Dates

• First Submitted: August 12, 2020
• First Submitted That Met QC Criteria: August 14, 2020
• First Posted (ACTUAL): August 17, 2020

Study Record Updates

• Last Update Posted (ACTUAL): February 4, 2021
• Last Update Submitted That Met QC Criteria: February 3, 2021
• Last Verified: February 1, 2021

More Information

Terms related to this study

• Other Study ID Numbers: STUDY20070012; DP2LM012339 (NIH)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: De-identified data is available for sharing, conditional on approval by the University of Pittsburgh Office of Research and Institutional Review Board.
• IPD Sharing Time Frame: 3 years
• IPD Sharing Access Criteria: Contact the PI
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ANALYTIC_CODE

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No