Clinical trial · Interventional
Predictive Analytics and Behavioral Nudges to Improve Palliative Care in Advanced Cancer
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
Patients with advanced cancer suffer from high symptom burden and aggressive end-of-life care. Early specialty palliative care is an evidence-based practice that improves symptom burden, quality of life, and survival in advanced cancer. However, over half of patients with advanced cancer die before receiving palliative care. Clinician-level biases and suboptimal identification of high-risk patients are major barriers to palliative care uptake. In this 2-arm pragmatic clinical trial, the investigators will randomize practices within a large community oncology network to receive an intervention consisting of algorithm-based default palliative care referrals. The investigators will study the impact of such an intervention on palliative care utilization and end-of-life outcomes.
Conditions
Conditions (1)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Cancer | Malignant Neoplasm | ALIAS | 0.90 |
Interventions
Interventions (1)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| EHR Nudge | Other | — | UNRESOLVED |
Design
Arms and outcomes
Arms (2)
- type
- NO_INTERVENTION
- label
- Control
- description
- Clinicians of patients in both arms will receive education on the availability of early palliative care and performance reports. Clinicians will receive no further interventions beyond usual practice.
- type
- EXPERIMENTAL
- label
- Intervention
- description
- Clinicians of patients in both arms will receive education on the availability of early palliative care and performance reports. Clinicians in the intervention arm will receive an EHR nudge with option to opt-out for palliative care referral for any eligible high-risk patient.
- interventionNames
- Other: EHR Nudge
Primary outcomes (1)
- measure
- Number of Study Participants Who Have Completed a Palliative Care Visit Within 3 Months of Enrollment
- timeFrame
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
Show eligibility criteria text
Inclusion Criteria: Patients: \- Stage III and IV lung, and non-Colorectal GI cancers, defined using internal algorithms based on International Classification of Diseases (ICD) diagnosis codes, EHR entries, and manual screening Exclusion Criteria: Patients: * Benign hematology, genetics, survivorship encounters; no prior EHR data; * Deceased or enrolled in hospice care * Had a palliative care visit or had no medical oncology visit within the prior 90 days or are seen for a non-medical oncology encounter
References
Publications (1)
- DERIVEDParikh RB, Ferrell WJ, Li Y, Chen J, Bilbrey L, Johnson N, White J, Sedhom R, Dickson NR, Schleicher S, Bekelman JE, Mudumbi S. Algorithm-Based Palliative Care in Patients With Cancer: A Cluster Randomized Clinical Trial. JAMA Netw Open. 2025 Feb 3;8(2):e2458576. doi: 10.1001/jamanetworkopen.2024.58576. PMID 39982729