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| ID | Type | Description | Link |
|---|---|---|---|
| 20PRE35120492 | Other Grant/Funding Number | American Heart Association | |
| 1F30HL152526-01 | U.S. NIH Grant/Contract | View source |
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Publicly available outcome assessments for transplant programs do not make salient that some programs tend to reject many of the hearts they are offered, whereas other programs accept a broader range of donor offers. The investigators use empirical studies to test whether transplant center performance data (i.e. transplant and waitlist outcome statistics) that reflect center donor acceptance rates influence laypersons to evaluate centers with high organ decline rates less favorably than centers with low organ decline rates. 1000 lay participants will be recruited from Amazon Mechanical Turk and randomized to one of five different information presentation conditions. Participants will be given an introduction to the donor organ match process, then asked to view the table of transplant outcomes corresponding to the condition they were randomized to. Each participant is asked to choose between two hospitals: one hospital with an non-selective, "accepting" strategy (takes all donor heart offers), and one hospital with a more selective, "cherrypicking" strategy (tends to reject donor offers that are less than "excellent" quality).
Publicly available outcome assessments for transplant programs do not make salient that some programs tend to reject many of the hearts they are offered, whereas other programs accept a broader range of donor offers. The investigators use empirical studies to test whether transplant center performance data (i.e. transplant and waitlist outcome statistics) that reflect center donor acceptance rates influence laypersons to evaluate centers with high organ decline rates less favorably than centers with low organ decline rates. 1000 lay participants will be recruited from Amazon Mechanical Turk and randomized to one of five different information presentation conditions:
Participants will be given an introduction to the donor organ match process, then asked to view the table of transplant outcomes corresponding to the condition they were randomized to. Each participant is asked to choose between two hospitals: one hospital with an non-selective, "accepting" strategy (takes all donor heart offers), and one hospital with a more selective, "cherrypicking" strategy (tends to reject donor offers that are less than "excellent" quality). In order to identify the decision process that underlies this choice pattern, the investigators will examine a putative mediator. Specifically, participants will be asked to rate the extent to which they considered patients' chances of getting an excellent heart, avoiding a less-than-optimal heart, and getting any type of heart when making their choice between the two hospitals.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Condition 1: Combined only | No Intervention | Participants randomized to baseline (control) arm Condition 1 will view only combined transplant survival outcome information (e.g. transplant survival rate not stratified by number and quality of donor hearts accepted at each center) when making a choice between the two hospitals. | |
| Condition 2: Combined plus Total | Experimental | Participants randomized to Condition 2 will view combined transplant survival and total survival outcome information when making a choice between the two hospitals. |
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| Condition 3: Stratified only | Experimental | Participants randomized to Condition 3 will view only stratified transplant survival outcome information when making a choice between the two hospitals. |
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| Condition 4: Stratified plus Total | Experimental | Participants randomized to Condition 4 will view stratified transplant survival and total survival outcome information when making a choice between the two hospitals. |
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| Condition 5: Total only | Experimental | Participants randomized to Condition 5 will view only total survival outcome information when making a choice between the two hospitals. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Total Survival | Other | The overall or "total" survival rate at each center is displayed in the table of outcome statistics. Total survival is computed from survival rates of both transplant and waitlist patients: [(number of patients surviving after transplant at end of year + number of patients alive on waitlist at end of year)] / [number of patients alive on waitlist at start of year]. |
| Measure | Description | Time Frame |
|---|---|---|
| Hospital Choice | The outcome variable will be a measure of binary choice between two hospitals: one with a selective donor-heart acceptance strategy and one with a non-selective donor heart acceptance strategy. Participants will respond to the question "Which Hospital is a better choice for patients? Please click on one of the two tables below to indicate which hospital is the better choice." Participants will choose been two outcome tables featuring the selective and non-selective hospital (counterbalanced, such that each of the two choices is equally likely to be presented at top of the choice scenario in each condition). The number of participants that choose each hospital will be the measured outcome variable used in analyses. | 1 day |
| Measure | Description | Time Frame |
|---|---|---|
| Mediator of Hospital Choice | Participants responded to the question, "There are many reasons why one transplant hospital might outperform another. Which reasons were most important in your decision? Please move the slider to indicate how much you considered each of the reasons below (0=reason was not important, 100=reason was extremely important). Patients were more likely to receive any type of donor heart at the hospital I picked. |
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Inclusion Criteria:
Participants who are already qualified mTurk workers with Worker Accounts meeting the above criteria will be asked to participate if they confirm the following inclusion criteria in the consent form.
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Alison E Butler, BS | Carnegie Mellon University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Carnegie Mellon University | Pittsburgh | Pennsylvania | 15213 | United States |
The PI will make all of the raw IPD files - together with statistical analysis protocol descriptions and information for proper analysis available for download a minimum of 1 year, and a maximum of 3 years, after publication of the corresponding manuscripts. All human subjects data are anonymized immediately when they are initially written from the online survey platform to the server, and thus participant confidentiality will not be compromised by this plan for data sharing.
All hypotheses, methods, and planned analyses for the applicant's studies will be pre-registered on ClinicalTrials.gov and Open Science Framework.
All of the raw files, statistical analysis protocol descriptions, and information for proper analysis will be available for download a minimum of 1 year, and a maximum of 3 years, after publication of the corresponding manuscripts.
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| ID | Title | Description |
|---|---|---|
| FG000 | Condition 1: Combined Only | Participants randomized to baseline (control) arm Condition 1 will view only combined transplant survival outcome information (e.g. transplant survival rate not stratified by number and quality of donor hearts accepted at each center) when making a choice between the two hospitals. |
| FG001 | Condition 2: Combined Plus Total | Participants randomized to Condition 2 will view combined transplant survival and total survival outcome information when making a choice between the two hospitals. Total Survival: The overall or "total" survival rate at each center is displayed in the table of outcome statistics. Total survival is computed from survival rates of both transplant and waitlist patients: [(number of patients surviving after transplant at end of year + number of patients alive on waitlist at end of year)] / [number of patients alive on waitlist at start of year]. |
| FG002 | Condition 3: Stratified Only | Participants randomized to Condition 3 will view only stratified transplant survival outcome information when making a choice between the two hospitals. Stratified Transplant Survival: The transplant survival rate in the table of outcome statistics is stratified into two groups: (i) patients who received excellent donor organs and (ii) patients who received less than optimal donor organs. Stratified transplant survival is computed from survival rates of transplant patients who received each quality category of organ. excellent transplant survival = [number of patients surviving after transplant with excellent organ]/[number of patients for whom excellent organ was accepted for transplant] marginal transplant survival = [number of patients surviving after transplant with marginal organ]/[number of patients for whom marginal organ was accepted for transplant] |
| FG003 | Condition 4: Stratified Plus Total | Participants randomized to Condition 4 will view stratified transplant survival and total survival outcome information when making a choice between the two hospitals. Total Survival: The overall or "total" survival rate at each center is displayed in the table of outcome statistics. Total survival is computed from survival rates of both transplant and waitlist patients: [(number of patients surviving after transplant at end of year + number of patients alive on waitlist at end of year)] / [number of patients alive on waitlist at start of year]. Stratified Transplant Survival: The transplant survival rate in the table of outcome statistics is stratified into two groups: (i) patients who received excellent donor organs and (ii) patients who received less than optimal donor organs. Stratified transplant survival is computed from survival rates of transplant patients who received each quality category of organ. excellent transplant survival = [number of patients surviving after transplant with excellent organ]/[number of patients for whom excellent organ was accepted for transplant] marginal transplant survival = [number of patients surviving after transplant with marginal organ]/[number of patients for whom marginal organ was accepted for transplant] |
| FG004 | Condition 5: Total Only | Participants randomized to Condition 5 will view only total survival outcome information when making a choice between the two hospitals. Total Survival: The overall or "total" survival rate at each center is displayed in the table of outcome statistics. Total survival is computed from survival rates of both transplant and waitlist patients: [(number of patients surviving after transplant at end of year + number of patients alive on waitlist at end of year)] / [number of patients alive on waitlist at start of year]. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
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| ID | Title | Description |
|---|---|---|
| BG000 | Condition 1: Combined Only | Participants randomized to baseline (control) arm Condition 1 will view only combined transplant survival outcome information (e.g. transplant survival rate not stratified by number and quality of donor hearts accepted at each center) when making a choice between the two hospitals. |
| BG001 |
| Units | Counts |
|---|---|
| Participants |
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| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Hospital Choice | The outcome variable will be a measure of binary choice between two hospitals: one with a selective donor-heart acceptance strategy and one with a non-selective donor heart acceptance strategy. Participants will respond to the question "Which Hospital is a better choice for patients? Please click on one of the two tables below to indicate which hospital is the better choice." Participants will choose been two outcome tables featuring the selective and non-selective hospital (counterbalanced, such that each of the two choices is equally likely to be presented at top of the choice scenario in each condition). The number of participants that choose each hospital will be the measured outcome variable used in analyses. | Posted | Count of Participants | Participants | 1 day |
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3 months
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Condition 1: Combined Only | Participants randomized to baseline (control) arm Condition 1 will view only combined transplant survival outcome information (e.g. transplant survival rate not stratified by number and quality of donor hearts accepted at each center) when making a choice between the two hospitals. |
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Selection bias or underrepresentation of certain groups due to online worker platform.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Gretchen Chapman | Carnegie Mellon University | 412-268-3665 | gchapman@andrew.cmu.edu |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Jan 10, 2024 | Mar 21, 2024 | Prot_SAP_000.pdf |
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| Stratified Transplant Survival | Other | The transplant survival rate in the table of outcome statistics is stratified into two groups: (i) patients who received excellent donor organs and (ii) patients who received less than optimal donor organs. Stratified transplant survival is computed from survival rates of transplant patients who received each quality category of organ. excellent transplant survival = [number of patients surviving after transplant with excellent organ]/[number of patients for whom excellent organ was accepted for transplant] marginal transplant survival = [number of patients surviving after transplant with marginal organ]/[number of patients for whom marginal organ was accepted for transplant] |
|
| 1 day |
| Condition 2: Combined Plus Total |
Participants randomized to Condition 2 will view combined transplant survival and total survival outcome information when making a choice between the two hospitals. Total Survival: The overall or "total" survival rate at each center is displayed in the table of outcome statistics. Total survival is computed from survival rates of both transplant and waitlist patients: [(number of patients surviving after transplant at end of year + number of patients alive on waitlist at end of year)] / [number of patients alive on waitlist at start of year]. |
| BG002 | Condition 3: Stratified Only | Participants randomized to Condition 3 will view only stratified transplant survival outcome information when making a choice between the two hospitals. Stratified Transplant Survival: The transplant survival rate in the table of outcome statistics is stratified into two groups: (i) patients who received excellent donor organs and (ii) patients who received less than optimal donor organs. Stratified transplant survival is computed from survival rates of transplant patients who received each quality category of organ. excellent transplant survival = [number of patients surviving after transplant with excellent organ]/[number of patients for whom excellent organ was accepted for transplant] marginal transplant survival = [number of patients surviving after transplant with marginal organ]/[number of patients for whom marginal organ was accepted for transplant] |
| BG003 | Condition 4: Stratified Plus Total | Participants randomized to Condition 4 will view stratified transplant survival and total survival outcome information when making a choice between the two hospitals. Total Survival: The overall or "total" survival rate at each center is displayed in the table of outcome statistics. Total survival is computed from survival rates of both transplant and waitlist patients: [(number of patients surviving after transplant at end of year + number of patients alive on waitlist at end of year)] / [number of patients alive on waitlist at start of year]. Stratified Transplant Survival: The transplant survival rate in the table of outcome statistics is stratified into two groups: (i) patients who received excellent donor organs and (ii) patients who received less than optimal donor organs. Stratified transplant survival is computed from survival rates of transplant patients who received each quality category of organ. excellent transplant survival = [number of patients surviving after transplant with excellent organ]/[number of patients for whom excellent organ was accepted for transplant] marginal transplant survival = [number of patients surviving after transplant with marginal organ]/[number of patients for whom marginal organ was accepted for transplant] |
| BG004 | Condition 5: Total Only | Participants randomized to Condition 5 will view only total survival outcome information when making a choice between the two hospitals. Total Survival: The overall or "total" survival rate at each center is displayed in the table of outcome statistics. Total survival is computed from survival rates of both transplant and waitlist patients: [(number of patients surviving after transplant at end of year + number of patients alive on waitlist at end of year)] / [number of patients alive on waitlist at start of year]. |
| BG005 | Total | Total of all reporting groups |
| Participants |
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| Sex/Gender, Customized | Count of Participants | Participants |
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| Race (NIH/OMB) | Count of Participants | Participants |
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| Region of Enrollment | Number | participants |
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| OG001 | Condition 2: Combined Plus Total | Participants randomized to Condition 2 will view combined transplant survival and total survival outcome information when making a choice between the two hospitals. Total Survival: The overall or "total" survival rate at each center is displayed in the table of outcome statistics. Total survival is computed from survival rates of both transplant and waitlist patients: [(number of patients surviving after transplant at end of year + number of patients alive on waitlist at end of year)] / [number of patients alive on waitlist at start of year]. |
| OG002 | Condition 3: Stratified Only | Participants randomized to Condition 3 will view only stratified transplant survival outcome information when making a choice between the two hospitals. Stratified Transplant Survival: The transplant survival rate in the table of outcome statistics is stratified into two groups: (i) patients who received excellent donor organs and (ii) patients who received less than optimal donor organs. Stratified transplant survival is computed from survival rates of transplant patients who received each quality category of organ. excellent transplant survival = [number of patients surviving after transplant with excellent organ]/[number of patients for whom excellent organ was accepted for transplant] marginal transplant survival = [number of patients surviving after transplant with marginal organ]/[number of patients for whom marginal organ was accepted for transplant] |
| OG003 | Condition 4: Stratified Plus Total | Participants randomized to Condition 4 will view stratified transplant survival and total survival outcome information when making a choice between the two hospitals. Total Survival: The overall or "total" survival rate at each center is displayed in the table of outcome statistics. Total survival is computed from survival rates of both transplant and waitlist patients: [(number of patients surviving after transplant at end of year + number of patients alive on waitlist at end of year)] / [number of patients alive on waitlist at start of year]. Stratified Transplant Survival: The transplant survival rate in the table of outcome statistics is stratified into two groups: (i) patients who received excellent donor organs and (ii) patients who received less than optimal donor organs. Stratified transplant survival is computed from survival rates of transplant patients who received each quality category of organ. excellent transplant survival = [number of patients surviving after transplant with excellent organ]/[number of patients for whom excellent organ was accepted for transplant] marginal transplant survival = [number of patients surviving after transplant with marginal organ]/[number of patients for whom marginal organ was accepted for transplant] |
| OG004 | Condition 5: Total Only | Participants randomized to Condition 5 will view only total survival outcome information when making a choice between the two hospitals. Total Survival: The overall or "total" survival rate at each center is displayed in the table of outcome statistics. Total survival is computed from survival rates of both transplant and waitlist patients: [(number of patients surviving after transplant at end of year + number of patients alive on waitlist at end of year)] / [number of patients alive on waitlist at start of year]. |
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| Secondary | Mediator of Hospital Choice | Participants responded to the question, "There are many reasons why one transplant hospital might outperform another. Which reasons were most important in your decision? Please move the slider to indicate how much you considered each of the reasons below (0=reason was not important, 100=reason was extremely important). Patients were more likely to receive any type of donor heart at the hospital I picked. | Posted | Mean | Standard Deviation | score on a scale | 1 day |
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| 0 |
| 183 |
| 0 |
| 183 |
| 0 |
| 183 |
| EG001 | Condition 2: Combined Plus Total | Participants randomized to Condition 2 will view combined transplant survival and total survival outcome information when making a choice between the two hospitals. Total Survival: The overall or "total" survival rate at each center is displayed in the table of outcome statistics. Total survival is computed from survival rates of both transplant and waitlist patients: [(number of patients surviving after transplant at end of year + number of patients alive on waitlist at end of year)] / [number of patients alive on waitlist at start of year]. | 0 | 194 | 0 | 194 | 0 | 194 |
| EG002 | Condition 3: Stratified Only | Participants randomized to Condition 3 will view only stratified transplant survival outcome information when making a choice between the two hospitals. Stratified Transplant Survival: The transplant survival rate in the table of outcome statistics is stratified into two groups: (i) patients who received excellent donor organs and (ii) patients who received less than optimal donor organs. Stratified transplant survival is computed from survival rates of transplant patients who received each quality category of organ. excellent transplant survival = [number of patients surviving after transplant with excellent organ]/[number of patients for whom excellent organ was accepted for transplant] marginal transplant survival = [number of patients surviving after transplant with marginal organ]/[number of patients for whom marginal organ was accepted for transplant] | 0 | 192 | 0 | 192 | 0 | 192 |
| EG003 | Condition 4: Stratified Plus Total | Participants randomized to Condition 4 will view stratified transplant survival and total survival outcome information when making a choice between the two hospitals. Total Survival: The overall or "total" survival rate at each center is displayed in the table of outcome statistics. Total survival is computed from survival rates of both transplant and waitlist patients: [(number of patients surviving after transplant at end of year + number of patients alive on waitlist at end of year)] / [number of patients alive on waitlist at start of year]. Stratified Transplant Survival: The transplant survival rate in the table of outcome statistics is stratified into two groups: (i) patients who received excellent donor organs and (ii) patients who received less than optimal donor organs. Stratified transplant survival is computed from survival rates of transplant patients who received each quality category of organ. excellent transplant survival = [number of patients surviving after transplant with excellent organ]/[number of patients for whom excellent organ was accepted for transplant] marginal transplant survival = [number of patients surviving after transplant with marginal organ]/[number of patients for whom marginal organ was accepted for transplant] | 0 | 209 | 0 | 209 | 0 | 209 |
| EG004 | Condition 5: Total Only | Participants randomized to Condition 5 will view only total survival outcome information when making a choice between the two hospitals. Total Survival: The overall or "total" survival rate at each center is displayed in the table of outcome statistics. Total survival is computed from survival rates of both transplant and waitlist patients: [(number of patients surviving after transplant at end of year + number of patients alive on waitlist at end of year)] / [number of patients alive on waitlist at start of year]. | 0 | 241 | 0 | 241 | 0 | 241 |
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