Implementation Strategy Training for Liver Cancer

(OASIS Trial)

Overseen By Shari S Rogal, MD MPH

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: VA Office of Research and Development

Disqualifiers: Post-transplant, Hepatocellular carcinoma

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

8020 Participants Needed

Trial Summary

Do I need to stop my current medications for this trial?

The trial protocol does not specify whether you need to stop taking your current medications.

What data supports the effectiveness of the treatment Current DA Tool training, OASIS DA training for liver cancer?

The research highlights the importance of quality indicators (QIs) in improving the management of liver cancer, suggesting that adherence to best practice guidelines can enhance patient outcomes. While not directly about the specific training, this implies that structured approaches like the Current DA Tool and OASIS DA training could potentially improve care quality by aligning with these QIs. ^{1 2 3 4 5}

How is the Implementation Strategy Training for Liver Cancer treatment different from other treatments?

This treatment is unique because it focuses on training and implementation strategies rather than a specific drug or medical procedure. It aims to improve the skills and knowledge of healthcare providers in delivering effective liver cancer care, which can enhance the overall treatment process. ^{6 7 8 9 10}

What is the purpose of this trial?

This trial tests a new decision aid tool that uses machine learning to help healthcare providers choose the best strategies for implementing effective medical practices. The focus is on Veterans with cirrhosis who need cancer screenings. The tool aims to improve screening rates by identifying and overcoming barriers specific to each medical center.

Research Team

Shari S. Rogal, MD MPH

Principal Investigator

VA Pittsburgh Healthcare System University Drive Division, Pittsburgh, PA

Eligibility Criteria

This trial is for veterans who've had recent medical care at a VA center and have liver cirrhosis or related complications, as well as healthcare providers involved in improving care at these centers. It's not for those who've had a liver transplant or currently have active liver cancer.

Inclusion Criteria

Veterans with two outpatient or one inpatient codes for cirrhosis or its complications who had an encounter in the prior 18 months at a participating VA medical center

Physicians, advance practice providers, nurses, leadership, and staff engaged with selecting and applying implementation strategies to improve care at a participating VA medical center

Exclusion Criteria

I am a veteran who has undergone a transplant.

I am a veteran with active liver cancer.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Training

Sites receive training on either the OASIS decision aid or the current decision aid tool

4 weeks

1 visit (in-person)

Intervention

Implementation of the decision aid tools at VA medical centers to improve HCC screening rates

6 months

Quarterly assessments

Follow-up

Participants are monitored for effectiveness and maintenance of the intervention

6 months

Quarterly assessments

Treatment Details

Interventions

• Current DA Tool training
• OASIS DA training

Trial Overview Project OASIS is testing a new decision aid tool against the current one to see which better identifies barriers and matches strategies to improve healthcare implementation. This study randomly assigns different VA centers to use either the new or current tool.

Participant Groups

Group I: OASIS DA Experimental Treatment 1 Intervention

Half of the sites will be randomized to receive training on the OASIS decision aid.

Group II: Current DA Tool Active Control 1 Intervention

Half of the sites will be randomized to receive training on the current decision aid tool.

Who Is Running the Clinical Trial?

VA Office of Research and Development

Lead Sponsor

Trials

1,691

Recruited

3,759,000+

VA Palo Alto Health Care System

Collaborator

Trials

97

Recruited

58,500+

VA Ann Arbor Healthcare System

Collaborator

Trials

19

Recruited

10,300+

VA Pittsburgh Healthcare System

Collaborator

Trials

36

Recruited

15,900+

References

1. United States pubmed.ncbi.nlm.nih.gov

Pancreatic Cancer Multidisciplinary Clinic is Associated with Improved Treatment and Elimination of Socioeconomic Disparities. [2023]

2. Netherlands pubmed.ncbi.nlm.nih.gov

Demonstration of quality of care measurement using the Japanese liver cancer registry. [2020]

3. United States pubmed.ncbi.nlm.nih.gov

Breast cancer treatment guidelines in older women. [2007]

4. Egypt pubmed.ncbi.nlm.nih.gov

Staged Nursing Intervention: The Effect of the Compliance in Liver Cancer Patients with Interventional Therapy. [2023]

5. United States pubmed.ncbi.nlm.nih.gov

Monitoring quality of care in hepatocellular carcinoma: A modified Delphi consensus. [2022]

6. England pubmed.ncbi.nlm.nih.gov

A competency-based tool for education. [2019]

7. England pubmed.ncbi.nlm.nih.gov

The "secret sauce" for a mentored training program: qualitative perspectives of trainees in implementation research for cancer control. [2022]

8. United States pubmed.ncbi.nlm.nih.gov

Building the Next Generation of Researchers: Mentored Training in Dissemination and Implementation Science. [2023]

9. England pubmed.ncbi.nlm.nih.gov

Comparing the CFIR-ERIC matching tool recommendations to real-world strategy effectiveness data: a mixed-methods study in the Veterans Health Administration. [2023]

10. England pubmed.ncbi.nlm.nih.gov

Oncology training and education initiatives in low and middle income countries: a scoping review. [2022]