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PI decision
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This project aims to evaluate whether rapid first contact with the oncologist the same day or the next day after pathologic diagnosis contributes to a decreased time to treatment, decreased patient anxiety and increased patient satisfaction.
Time to treatment (time from disease diagnosis to initiation of treatment) impacts outcomes in uterine cancer. When controlled for stage, patients with longer time to treatment tend to have less favorable outcomes. Similarly, longer time to treatment has a negative impact on patients' quality of life and markers for anxiety. Our experience at this institution suggests that the time to referral (time from uterine cancer diagnosis and the patients' first encounter with the oncologist) is variable and presents the greatest opportunity for decreasing time to treatment. Among the factors that contribute to the time to referral are the time taken by the referring provider to relay the diagnosis to the patient, time taken to schedule an appointment with the specialist, and the patient's availability to keep an appointment.
Virtual visits provide an opportunity to expedite consultation with the treating oncologist by removing some of the barriers that delay face-to-face visits. Among these barriers are patients' availability for a short notice face-to-face visit based on their work or family obligations, access to transportation, and mental preparedness.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Rapid first contact virtual visit | Active Comparator | Subjects will accept the offer of a virtual visit after being contacted by the nurse to offer a virtual visit with the oncologist prior to the in person office visit once a diagnosis has been confirmed. Subjects will be randomized after accepting offer of a virtual visit. |
|
| First contact in person office visit | Placebo Comparator | Subjects will accept the offer of a virtual visit after being contacted by the nurse to offer a virtual visit with the oncologist prior to the in person office visit once a diagnosis has been confirmed. Subjects will be randomized after accepting offer of a virtual visit. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Virtual visit | Behavioral | Virtual visit with oncologist following uterine cancer diagnosis prior to scheduled office visit. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Time to treatment following diagnosis to treatment initiation | How long between diagnosis to treatment | 30 days |
| Measure | Description | Time Frame |
|---|---|---|
| Amount of anxiety demonstrated when virtual visits are added | Level of anxiety using GAD-7 | 30 days |
| Number of patients willing to pay for a virtual visit | Assess patients valuation of virtual visits by measuring their willingness to pay |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Jason Knight, MD | Cleveland Clinic, Case Comprehensive Cancer Center | Principal Investigator |
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| ID | Term |
|---|---|
| D014594 | Uterine Neoplasms |
| ID | Term |
|---|---|
| D005833 | Genital Neoplasms, Female |
| D014565 | Urogenital Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
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| ID | Term |
|---|---|
| D009819 | Office Visits |
| ID | Term |
|---|---|
| D011364 | Professional Practice |
| D009934 | Organization and Administration |
| D006298 | Health Services Administration |
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| Office visit | Behavioral | Scheduled office visit with oncologist following uterine cancer diagnosis. |
|
| 30 days |
| Number of patients with improved satisfaction scores | Determine whether the addition of a rapid virtual visit improves patients satisfaction | 30 days |
| D014591 |
| Uterine Diseases |
| D005831 | Genital Diseases, Female |
| D052776 | Female Urogenital Diseases |
| D005261 | Female Urogenital Diseases and Pregnancy Complications |
| D000091642 | Urogenital Diseases |
| D000091662 | Genital Diseases |