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Decision Aid for Parents of Infants With UPJO

Primary Purpose

Ureteropelvic Junction Obstruction, Ureteropelvic Junction; Obstruction, Congenital

Status
Not yet recruiting
Phase
Not Applicable
Locations
United States
Study Type
Interventional
Intervention
Parent Decision Aid
Sponsored by
University of Colorado, Denver
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional health services research trial for Ureteropelvic Junction Obstruction focused on measuring shared decision making, pragmatic trial, congenital kidney anomaly

Eligibility Criteria

18 Years - 89 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria (all of following are needed): parents (age 18-89 years) of children age 30 days - 2 years child is presenting for consultation for SFU grade 3-4 Hydronephrosis at Children's Hospital Colorado parents/child presenting at Urology appointment where a MAG 3 is performed or has recently been performed. Exclusion Criteria: does not meet age parameters does not have a child with a UPJO

Sites / Locations

  • Children's Hospital Colorado

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

No Intervention

Arm Label

Intervention Arm - Receipt of PtDA

Control - Usual Care

Arm Description

Parents in the intervention arm will receive a paper decision aid prior to meeting with their health care professional about their child's treatment options for UPJO.

Parents in the control arm will not receive a paper decision aid and instead will just receive usual care about their child's treatment options for UPJO.

Outcomes

Primary Outcome Measures

Differences in the SDM-Q9 scores between arms
The primary outcome will be differences in scores between the 9-item Shared Decision Making Questionnaire (SDM-Q9) survey scores between intervention and control arms. The SDM-Q9 is a validated survey instrument measuring patient understanding and engagement in the decision making process. The scale for each question is 1-5 and higher scores mean better parent involvment and understanding.

Secondary Outcome Measures

Assess differences in treatment decisions
The surgical rates of each patient will be assessed in each arm. Demographic variables will be controlled for especially race, ethnicity, socioeconomic variables.

Full Information

First Posted
May 31, 2023
Last Updated
June 12, 2023
Sponsor
University of Colorado, Denver
Collaborators
Children's Hospital Colorado
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1. Study Identification

Unique Protocol Identification Number
NCT05900375
Brief Title
Decision Aid for Parents of Infants With UPJO
Official Title
Pilot-testing of a Decision Aid for Parents of Infants With Ureteropelvic Junction Obstruction (UPJO)
Study Type
Interventional

2. Study Status

Record Verification Date
June 2023
Overall Recruitment Status
Not yet recruiting
Study Start Date
June 15, 2023 (Anticipated)
Primary Completion Date
December 31, 2024 (Anticipated)
Study Completion Date
December 31, 2024 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
University of Colorado, Denver
Collaborators
Children's Hospital Colorado

4. Oversight

Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No

5. Study Description

Brief Summary
Ureteropelvic junction obstruction (UPJO) is the most common etiology of high-grade hydronephrosis, affecting approximately 4,000-10,000 infants annually in the U.S. The goal of surgical treatment of UPJO is to minimize the risk of kidney damage associated with obstruction, which may occur in 30-60% of infants with high-grade hydronephrosis.1-However, the benefit of early surgery compared to observation and potential later surgery to preserve kidney function has not been well-defined. Consequently, surgeons differ on whether to initially treat with surgery or observation, with surgical rates in the first year of life varying from 15-50% across surgical practices. These variations are important to understand, as the decision for early surgery is not without risk. Prior studies suggest that infants treated surgically are at higher risk for readmission and reoperation. Early surgery also raises concerns about neurodevelopmental effects of anesthetic exposure. To address this gap, the purpose of this pilot test is to develop a patient decision aid (PtDA) tool and pilot test its effect on parental understanding and engagement in the decision-making process at Children's Hospital Colorado. The proposed pilot is a necessary first step in preparation for a future multicenter hybrid effectiveness-implementation trial. This work will also be used to support future studies evaluating the impact of a PtDA on surgical variations and treatment outcomes in patients with UPJO and other complex congenital urologic anomalies.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Ureteropelvic Junction Obstruction, Ureteropelvic Junction; Obstruction, Congenital
Keywords
shared decision making, pragmatic trial, congenital kidney anomaly

7. Study Design

Primary Purpose
Health Services Research
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
None (Open Label)
Allocation
Randomized
Enrollment
100 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Intervention Arm - Receipt of PtDA
Arm Type
Experimental
Arm Description
Parents in the intervention arm will receive a paper decision aid prior to meeting with their health care professional about their child's treatment options for UPJO.
Arm Title
Control - Usual Care
Arm Type
No Intervention
Arm Description
Parents in the control arm will not receive a paper decision aid and instead will just receive usual care about their child's treatment options for UPJO.
Intervention Type
Behavioral
Intervention Name(s)
Parent Decision Aid
Intervention Description
A paper parent decision aid in color will be provided to all patients at the time of their appointment and will aid in discussion with health care professionals.
Primary Outcome Measure Information:
Title
Differences in the SDM-Q9 scores between arms
Description
The primary outcome will be differences in scores between the 9-item Shared Decision Making Questionnaire (SDM-Q9) survey scores between intervention and control arms. The SDM-Q9 is a validated survey instrument measuring patient understanding and engagement in the decision making process. The scale for each question is 1-5 and higher scores mean better parent involvment and understanding.
Time Frame
through study completion, an average of 1 year
Secondary Outcome Measure Information:
Title
Assess differences in treatment decisions
Description
The surgical rates of each patient will be assessed in each arm. Demographic variables will be controlled for especially race, ethnicity, socioeconomic variables.
Time Frame
through study completion, an average of 1 year

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
89 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria (all of following are needed): parents (age 18-89 years) of children age 30 days - 2 years child is presenting for consultation for SFU grade 3-4 Hydronephrosis at Children's Hospital Colorado parents/child presenting at Urology appointment where a MAG 3 is performed or has recently been performed. Exclusion Criteria: does not meet age parameters does not have a child with a UPJO
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Alison Saville, MSPH, MSW
Phone
7202574406
Email
alison.saville@cuanschutz.edu
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Vijaya Vemulakonda, MD, JD
Organizational Affiliation
Children's Hospital Colorado
Official's Role
Principal Investigator
Facility Information:
Facility Name
Children's Hospital Colorado
City
Aurora
State/Province
Colorado
ZIP/Postal Code
80045
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No
IPD Sharing Plan Description
Since the population affected is a small vulnerable population it is not ideal to share individual level data. Data sharing is possible if in aggregate form. Guides that are developed will be shared after publication.

Learn more about this trial

Decision Aid for Parents of Infants With UPJO

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