NCT07147023

Better Real-time Information on Documentation of Goals of Care for Engagement in Serious Illness Communication

• Status: Active Not Recruiting
• Phase: N/A
• Study type: Interventional
• Enrollment: 60 (actual)
• Sponsor: Dana-Farber Cancer Institute · Academic / Other
• Sex: All
• Age: 18 Years
• Healthy volunteers: Not accepted

Summary

The goal of this study is to test the accuracy of Large Language Model-generated serious illness communication (SIC) summaries, the feasibility of delivering the SIC summaries, and to collect perspectives on the SIC summaries from clinicians and participants with cancer. Large Language Models (LLMs) are artificial intelligence programs that can perform various natural language processing tasks.

Detailed description

The study will enroll up to 70 Dana-Farber patients admitted to Brigham and Women's hospital who have an elevated mortality prediction at admission. The research study procedures include randomization to intervention or control arms on admission (3:1 intervention to control). For patients in the intervention arm, a large language model query will summarize serious illness communication documentation in their medical record screening from the prior 6 months. A summary of the documentation will be sent to the inpatient and outpatient oncology clinicians within 24 hours of admission; these clinicians will be asked to review the summaries, discuss with the patient and incorporate into care plans as appropriate. For patients with no SIC documented on day 4 of the admission, a second email will be sent. Control patients will receive usual care, which is no email sent to their oncology teams. All patients will be offered to participate in an interview on day 4 of their admission about their communication with their care teams. For patients in both arms, inpatient and outpatient oncology attendings will be sent an email survey regarding SIC for the patient and, if applicable, the utility of the SIC summaries.

Conditions

• Advanced Cancer
• Cancer
• End of Life

Interventions

Type	Name	Description
OTHER	LLM SIC Summary Email	A Large Language Model-based platform is integrated with the Health Vision Platform, a HIPAA-compliant, electronic health record data management system. Real-time summaries of prior SIC with be sent to clinicians caring for participants in the intervention arm. An email will be sent to the inpatient attending and responding clinician encouraging the team to review the SIC summary, discuss care preferences with the patient and ensure care is aligned with preferences and goals. If no SIC documentation is found, the email will instead encourage the outpatient oncologist to share information regarding undocumented SICs that may have occurred, as well as prompt inpatient and outpatient teams to engage the patient in SIC. For patients with no SIC documentation who are still admitted 72 hours later, the RA will send an additional email prompting SIC or asking the clinician to indicate that an SIC is not appropriate. Patients will also receive standard of care.

Timeline

• Start date: 2025-09-15
• Primary completion: 2026-03-31
• Completion: 2026-10-31
• First posted: 2025-08-28
• Last updated: 2026-02-09

Locations

2 sites across 1 country: United States