NCT04867850

Effect of Behavioral Nudges to Clinicians, Patients, or Both on Serious Illness Conversation Documentation for Patients With Cancer

Extracted Fields (from Registry)
Protocol IDNCT04867850
Registration Date2021-04-30
Statuscompleted
SponsorAbramson Cancer Center at Penn Medicine
CountryUnited States
Industrynot industry
Blindingblinded
Center Typesingel-center RCT
Scopenational RCT
First Patient In2021-09-09
Last Patient Out2022-09-09
Publicationy
Gender %ALL
Mean Age18 Years -
LLM Classifications (Side-by-Side)
Field CLAUDE
claude-sonnet-4-20250514
Thinking: claude-opus-4-20250514
5199ms / 11502 tok 		GLM
glm-5.1
6510ms / 10155 tok 		OPENAI
gpt-4o
Thinking: o3
5666ms / 9954 tok 		Review
rct_type Cluster RCT Cluster RCT Cluster RCT OK
cancer_status Cancer Cancer Cancer OK
non_cancer_spec N/A N/A N/A OK
setting_patient outpatient outpatient outpatient OK
setting_place other other → other
shaky reasoning
✓ Unanimous Initial: other Requery: other — The intervention involves outpatient clinic visits and electronic messaging delivered to both clinicians and patients in an ambulatory cancer care setting at Penn Medicine practice sites.
 other other hospital → other
shaky reasoning
✓ Unanimous Initial: hospital Requery: other — The intervention involves outpatient visits and telemedicine at PennMedicine clinics, not requiring hospital admission.
 OK
feasibility fully powered RCT fully powered RCT fully powered RCT OK
intervention_pharmacologic no no no OK
intervention_chemo_immuno_radio no no no OK
intervention_complementary no no no OK
intervention_device no no no OK
intervention_psychological no no no OK
intervention_complex no no → no → no
shaky reasoning
✓ Unanimous Initial: no Requery: no — This study tests behavioral nudges (performance feedback, text messages, questionnaires) which are all implementation strategies of the same behavioral economics category, not distinct interacting components from different intervention types. Thinking: no — Both the clinician and patient nudges are behavioral economics interventions of the same type, not distinct intervention categories.
 yes no yes → yes → no
shaky reasoning
✓ Unanimous Initial: yes Requery: yes — The trial combines behavioral nudges directed at clinicians and patients, representing psychological and educational interventions that interact to increase Serious Illness Conversation documentation. Thinking: no — The intervention consists solely of behavioral nudges (messages/feedback) even when aimed at both clinicians and patients, so it remains a single-modality behavioral strategy rather than a multi-component intervention from different categories.
 –
intervention_acp yes yes yes OK
intervention_music no no no OK
intervention_screening no no no OK
intervention_palliative no no → no
shaky reasoning
✓ Unanimous Initial: no Requery: no — The intervention tests behavioral nudges to improve documentation of serious illness conversations, not palliative care consultation or service delivery itself.
 no no yes → no
shaky reasoning
✓ Unanimous Initial: yes Requery: no — The trial focuses on behavioral nudges to increase Serious Illness Conversation documentation, not on palliative care as an intervention.
 OK
intervention_education no no no OK
intervention_digital yes yes yes OK
intervention_other no no no OK
outcome_symptom no no no OK
outcome_qol no no no OK
outcome_dignity no no no OK
outcome_cost no no → no
shaky reasoning
✓ Unanimous Initial: no Requery: no — The study measures clinical documentation rates, care processes, and quality metrics but does not evaluate costs, healthcare utilization from an economic perspective, or resource use for cost-effectiveness analysis.
 no no yes → no
shaky reasoning
✓ Unanimous Initial: yes Requery: no — The trial does not include any cost-effectiveness analysis, cost analysis, or healthcare utilization related to costs; it focuses primarily on increasing documentation of conversation topics, without a direct cost framing.
 OK
outcome_other yes yes yes OK
pharmacologic_sub N/A N/A N/A OK
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