Patient Perceptions Around Quality of Care Through Telemedicine in Neuro-Oncology

This study evaluates patient perceptions around quality of care through telemedicine in neuro-oncology. Studying questionnaires related to perceptions quality of care through telemedicine in patients with brain cancer may help doctors to improve the delivery of care through this modality.

Study Overview

• Status: Recruiting
• Conditions: Metastatic Malignant Neoplasm in the Brain; Central Nervous System Neoplasm; Leptomeningeal Neoplasm; Primary Brain Neoplasm
• Intervention / Treatment: Other: Survey Administration; Other: Electronic Health Record Review

Detailed Description

PRIMARY OBJECTIVE:

I. To evaluate the patient-perceived quality of care by group (telemedicine versus in-person visits) in patients with central nervous system (CNS) cancer.

SECONDARY OBJECTIVES:

I. To characterize the visits provided by telemedicine compared to those in-person.

II. To contrast the average time spent on telemedicine visits compared to in-person visits, and the delay between visit order placement and visit occurring.

III. To evaluate the domains of patient care addressed on a telemedicine visit versus in-person visit per documentation, including (1) treatment planning, (2) symptom burden, (3) goals of care.

IV. To evaluate frequency of acute care sought (through emergency room or urgent care clinic) within 30 days of encounter in telemedicine visit versus (vs) in-person visit.

V. The impact of patient and clinical characteristics on perceived quality of care in the context of covariate-adjusted modeling.

OUTLINE:

Patients complete a survey related to their perceived quality of care via telephone and have their medical chart reviewed prospectively.

• Study Type: Observational
• Enrollment (Estimated): 200

Contacts and Locations

• Study Contact: Name: Barbara J O'Brien, MD; Phone Number: 713-794-4380; Email: bjobrien@mdanderson.org

Study Locations

• United States
  • Texas
    • Houston, Texas, United States, 77030
      • Recruiting
      • M D Anderson Cancer Center
      • Contact: Barbara J O'Brien, MD; Phone Number: 713-794-4380; Email: bjobrien@mdanderson.org
      • Principal Investigator: Barbara J O'Brien, MD

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Patients with encounters at the Brain and Spine Center between 4/20/2020 and either (1) 8/30/2020 or (2) date that the state of emergency secondary to the COVID-19 pandemic is declared terminated in the United States of America- whichever date is earlier

Description

Inclusion Criteria:

• Patients with a CNS tumors: this includes patients with primary brain tumors, brain metastases, and leptomeningeal disease

• Established patients with a follow up encounter with Neuro-Oncology at the Brain and Spine Center at the University of Texas MD Anderson Cancer Center; this encounter can be

  • An in-person visit
  • A telemedicine appointment

Exclusion Criteria:

• Encounter occurred with the assistance of official language translation support
• Patients with telephone encounters (without interactive video)
• New patient or consult visits
• Neither patient nor caregiver present during the visit are available or able to answer survey questions

Study Plan

How is the study designed?

Design Details

• Observational Models: Cohort
• Time Perspectives: Prospective

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Observational (survey, medical chart review); Patients complete a survey related to their perceived quality of care via telephone and have their medical chart reviewed prospectively.	Other: Survey Administration; Complete survey; Other: Electronic Health Record Review; Review of medical chart

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Survey response to question 6 of the quality of care survey ("I felt I received good medical care during this encounter")	Survey responses will be summarized by ordinal category as counts with percentages, separately by group. Will separately estimate the proportion of each ordinal level of each group with 95% confidence interval.	through study completion, an average of 1 year

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Quality of Care Survey	Will separately estimate the proportion of each ordinal level of each group with 95% confidence interval.	through study completion, an average of 1 year
Patients and clinical characteristics	Differences between groups will be assessed by 2-sample 2-sided t-test and Mann-Whitney test, Fisher's exact test, or chi-square test.	Baseline
Interactive time spent during visit	Will be summarized by group per mean, median, standard deviation, and range. Differences between groups will be assessed by t-test and Mann-Whitney test.	through study completion, an average of 1 year
Time from visit order placement to visit occurring	Will be summarized by group per mean, median, standard deviation, and range. Differences between groups will be assessed by t-test and Mann-Whitney test.	through study completion, an average of 1 year
Domains of patient care addressed during a visit, including treatment planning, symptom burden, and goals of care	Will be summarized as counts with percentages by group. Differences between groups will be assessed by chi-square test.	through study completion, an average of 1 year
Incidence of acute care sought (through emergency room or urgent care clinic)	Will be summarized as counts with percentages by group. Differences between groups will be provisionally assessed by Fisher's exact test.	Within 30 days of encounter

Collaborators and Investigators

• Sponsor: M.D. Anderson Cancer Center
• Investigators: Principal Investigator: Barbara J O'Brien, MD, M.D. Anderson Cancer Center

Publications and helpful links

Helpful Links

• University of Texas MD Anderson Cancer Center Website

Study record dates

Study Major Dates

• Study Start (Actual): August 20, 2020
• Primary Completion (Estimated): December 31, 2026
• Study Completion (Estimated): December 31, 2026

Study Registration Dates

• First Submitted: October 7, 2020
• First Submitted That Met QC Criteria: August 2, 2021
• First Posted (Actual): August 3, 2021

Study Record Updates

• Last Update Posted (Actual): March 15, 2024
• Last Update Submitted That Met QC Criteria: March 14, 2024
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Neoplasms by Site; Neoplasms; Brain Neoplasms; Nervous System Neoplasms; Central Nervous System Neoplasms; Meningeal Neoplasms
• Other Study ID Numbers: 2020-0493 (Other Identifier: M D Anderson Cancer Center); NCI-2020-07493 (Registry Identifier: CTRP (Clinical Trial Reporting Program))

Drug and device information, study documents

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