This page provides an independent statistical analysis and educational interpretation of publicly reported results. ClinicalTrials.gov provides the official trial registry record. Numerical trial results on this page are restricted to the results posted in the ClinicalTrials.gov record; calculations added by Clinical Biostats are labelled as such.
1. Trial at a Glance
This page covers the registry results for Translating Data Science to Palliative Care (NCT05942040), a non-randomized na study. The primary outcome is Palliative Care Refusal Rate.
| Feature | Registry value |
|---|---|
| ClinicalTrials.gov identifier | NCT05942040 |
| Phase | NA |
| Condition | Alzheimer's Disease and Related Dementias |
| Allocation | Non-Randomized |
| Design model | Parallel |
| Masking | None (open label) |
| Enrollment | 301 |
| Arms in the primary outcome | n/a |
| Lead sponsor | Rutgers, The State University of New Jersey |
| Results posted | Yes |
2. Clinical Question
Population
Eligible members of the VNS Health Total Medicare Advantage plan who could receive its community-based palliative care program are the primary population for the refusal-rate outcome. The study’s broader focus is seriously ill adults and family care partners, particularly people living with dementia and their family care partners. The record describes the outcome population as those eligible during the five months before the intervention or the five months during it.
Intervention
The intervention is tailored information about community-based palliative care. It includes informational material for the palliative care team to use when presenting the service, along with processes to tailor information delivery to reflect an eligible member’s individualized risk as identified by the Medicare Advantage program’s 12-month mortality risk algorithm.
Comparator
The control group is a retrospective review of eligible people who received usual care or information before tailored materials were introduced. It is a historical comparison, not a concurrently randomized control group. Differences between the periods could therefore reflect changes beyond the informational intervention.
Primary question
The primary question is whether the recorded refusal rate differs between the pre-intervention and intervention periods. The rate is defined as the number of eligible people refusing palliative care divided by the number eligible. The registry record does not report the underlying refusal counts, rates, or an estimated difference, so the direction and precision of any observed change cannot be assessed from the posted results.
3. Trial Design
This is a completed, nonrandomized, parallel-group study listed with phase as not applicable. The registry records enrollment of 301. Its stated purpose has three parts: to understand barriers to accepting community-based palliative care, develop an intervention to address barriers, and pilot test whether the intervention affects uptake. The clinical-trial portion is the pilot test of uptake.
The intervention group consists of eligible Medicare Advantage members after tailored informational materials were introduced. The control group consists of eligible people identified retrospectively from the period before introduction, when they received usual care or information. Because the groups come from different time periods rather than random assignment, the comparison is not like-for-like by design. Background changes over time, differences in who was eligible, or changes in care processes could contribute to a difference in refusal rates. The registry record does not describe adjustments intended to address such differences.
The primary outcome description specifies five months before intervention and five months during intervention, with an overall timeframe stated as baseline through 10 months. The arm descriptions also refer to a six-month period following introduction and a six-month pre-intervention review. These descriptions do not align completely. The precise implemented observation windows are not reported in the registry record beyond these statements.
Masking is listed as none. The intervention is tailored palliative care information, classified as another intervention type. A secondary outcome concerns satisfaction among community-based palliative care team members. The registry lists two outcome measures and one analysis, but does not report the statistical methods used for the primary comparison. No arm-specific refusal results or inferential estimates are reported in the registry record.
4. Participant Flow and Accounting
The registry reports how participants moved through each stage of the study. All counts below are exactly as posted; missing counts are not inferred from other stages.
Before assignment: 301 individuals enrolled in the study. 294 participants enrolled via a waiver of consent to retrospectively analyze electronic records (primary outcome only). Of these, 111 were in intervention; 182 in control. 7 participants were palliative care team members who provided satisfaction data (secondary outcome only). Of these 7, 1 individual dropped out of the study after consent and prior to providing any data. Reported results are based on 300 participants for whom data were provided.
Overall Study
| Stage | Intervention Group | Control Group | Community Based Palliative Care Team Members |
|---|---|---|---|
| STARTED | 111 | 182 | 7 |
| COMPLETED | 111 | 182 | 4 |
| NOT COMPLETED | 0 | 0 | 3 |
Reasons for not completing this period:
| Reason | Intervention Group | Control Group | Community Based Palliative Care Team Members |
|---|---|---|---|
| No longer employed at study site. | 0 | 0 | 3 |
Analysis population for the primary outcome, as defined in the registry: All participants who were eligible for the VNS Health Total Medicare Advantage plan's community-based palliative care program in the 5 months pre-intervention or 5-months post-intervention.
5. Baseline Characteristics
The table reproduces the baseline characteristics posted in the registry, which describe the participants analysed at baseline and help show whether the randomized groups were comparable.
| Characteristic | Unit | Intervention Group | Control Group | Community Based Palliative Care Team Members | Total |
|---|---|---|---|---|---|
| Participants analysed | 111 | 182 | 7 | 300 | |
| Age, Continuous | years | 84.7 (SD 10.7) | 86.5 (SD 11.1) | 50.1 (SD 12.6) | 84.0 (SD 11.0) |
| Sex: Female, Male: Female | Participants | 89 | 130 | 7 | 226 |
| Sex: Female, Male: Male | Participants | 22 | 52 | 0 | 74 |
| Ethnicity (NIH/OMB): Hispanic or Latino | Participants | 38 | 79 | 1 | 118 |
| Ethnicity (NIH/OMB): Not Hispanic or Latino | Participants | 0 | 0 | 6 | 6 |
| Ethnicity (NIH/OMB): Unknown or Not Reported | Participants | 73 | 103 | 0 | 176 |
| Race (NIH/OMB): American Indian or Alaska Native | Participants | 1 | 4 | 0 | 5 |
| Race (NIH/OMB): Asian | Participants | 14 | 13 | 0 | 27 |
| Race (NIH/OMB): Native Hawaiian or Other Pacific Islander | Participants | 0 | 0 | 0 | 0 |
| Race (NIH/OMB): Black or African American | Participants | 33 | 58 | 4 | 95 |
| Race (NIH/OMB): White | Participants | 36 | 80 | 2 | 118 |
| Race (NIH/OMB): More than one race | Participants | 6 | 8 | 0 | 14 |
| Race (NIH/OMB): Unknown or Not Reported | Participants | 21 | 19 | 1 | 41 |
| Region of Enrollment: United States | Participants | 111 | 182 | 7 | 300 |
| Palliative care refusal rate: Enrolled in Palliative Care | Participants | 50 | 69 | — | 119 |
| Palliative care refusal rate: Declined Palliative Care | Participants | 61 | 113 | — | 174 |
| Palliative care refusal rate: Did not contribute data | Participants | 0 | 0 | — | 0 |
| End-User Satisfaction Survey | units on a scale | — | — | 35.4 (SD 5.7) | 35.4 (SD 5.7) |
6. Primary Endpoint
The registry lists the primary outcome as Palliative Care Refusal Rate, measured over Baseline through 10 months. Pre (control group) test for 5 months prior to intervention. Post (intervention group) for 5 months during intervention..
| Element | Registry entry |
|---|---|
| Result type | Count Of Participants |
| Measure of spread | not applicable |
| Unit | Participants |
| Endpoint classification | Binary Endpoint |
The primary endpoint is the palliative care refusal rate among people eligible for the VNS Health Total Medicare Advantage plan’s community-based palliative care program. The registry defines the numerator as eligible individuals who refuse palliative care and the denominator as all eligible individuals. It says refusal will be assessed using the plan’s electronic health records. The outcome is described as binary, while the endpoint is expressed as a rate derived from counts.
This measure is used to assess uptake at the point when eligible members are offered or considered for the service. A refusal rate focuses on the decision among eligible people, rather than simply counting how many people received care. It is therefore relevant to the stated aim of examining barriers to acceptance and piloting an informational approach. However, a change in refusal rate alone would not identify why decisions changed, whether the information caused a change, or what happened after acceptance.
The record specifies a pre-intervention control period and an intervention period, but its arm descriptions refer to six months while the endpoint timeframe specifies five months for each period. It does not report the refusal counts, calculated rates, missing or incomplete records, or a measure of uncertainty. The primary endpoint’s observed result and its precision are therefore not reported in the registry record.
7. Why No Re-analysis Is Shown
8. Statistical Interpretation
The registry describes a pilot intended to test whether tailored information has an impact on community-based palliative care uptake. The posted results do not include the primary outcome values needed to assess that question. In particular, no refusal numerator, eligible-population denominator, refusal rate, between-period estimate, confidence interval, or p-value is reported in the registry record. The absence of these values means that the direction, size, and statistical precision of the primary comparison cannot be interpreted from this record.
The study’s comparison is nonrandomized and historical. Members in the intervention period are compared with people reviewed from an earlier period, rather than with a concurrent group assigned by chance. This design can be useful for a pilot of implementation in practice, but it does not by itself separate an intervention effect from temporal changes. For example, eligibility composition or usual care processes could differ between periods. The registry does not report whether these factors were measured, adjusted for, or otherwise addressed, so their influence on a potential comparison is unknown.
The endpoint is a refusal rate, with eligible people as the denominator. If a rate were reported, its interpretation would depend on consistent definitions of eligibility, refusal, and the observation period across the two groups. The record describes electronic health records as the source, but does not report how ambiguous decisions, incomplete records, or people with no documented decision were handled. It also gives different window lengths in the endpoint and arm descriptions. These uncertainties limit interpretation even before considering causal attribution.
The completed status indicates that the study is recorded as completed; it does not supply the outcome findings. Enrollment is recorded as 301, but that figure does not replace the outcome-specific denominators or refusal counts. The adverse-event entries report zero serious events, zero other events, and zero deaths in the listed groups, with numbers at risk also recorded. Those safety entries do not provide the missing uptake outcome.
Accordingly, the record supports a description of the intervention concept, comparator, and intended measurement, but not a conclusion about whether refusal changed. The sponsor’s analysis or additional posted results would be needed to judge the observed effect and its uncertainty. A non-significant result, a clinically important difference, or any other specific outcome cannot be inferred from the absence of reported estimates.
9. Statistical Methods Explained
What does the refusal rate represent?
In general, a rate formed from a binary outcome summarizes the proportion of eligible people who meet the outcome definition. Here, the registry defines refusal as the event and eligibility for community-based palliative care as the denominator. The numerator and denominator need consistent definitions: a person must be eligible under the stated criteria, and refusal must be recorded in a comparable way in both periods. The record identifies electronic health records as the source but does not describe detailed coding rules or handling of uncertain decisions.
A rate is more informative than a refusal count alone when the number of people eligible differs between comparison periods, because the denominator provides context for the count. But a rate does not remove bias from nonrandomized assignment. Nor does it explain the reasons for refusal. To interpret a comparison, readers would also need the actual rates and an estimate of their difference or another prespecified contrast, together with uncertainty. These results are not reported in the registry record.
Why does the historical comparison matter?
In general, random assignment helps make groups comparable on average by distributing measured and unmeasured characteristics across study arms. This study instead uses a retrospective pre-intervention control group and a later intervention group. The periods may differ in factors that affect eligibility, offers of care, documentation, or willingness to accept care. An observed rate difference, if reported, could therefore reflect the informational materials, other changes over time, or both. Statistical adjustment can address measured differences under appropriate assumptions, but it cannot guarantee that all relevant differences are accounted for. The registry does not report an adjustment strategy or the variables considered.
The record describes the study as parallel, but the two groups are separated in time. The label does not make the comparison randomized or concurrent. Masking is listed as none; the registry does not describe additional procedures to reduce the influence of knowledge about the intervention on recording decisions.
What would uncertainty measures add?
In general, a confidence interval expresses the range of estimates reasonably compatible with the observed data under a specified statistical model. A narrower interval indicates greater precision, while a wider interval indicates greater uncertainty. A p-value, when used, describes how incompatible the observed data are with a specified null model; it does not measure the probability that the intervention works or establish causation. No confidence interval or p-value for the primary outcome is reported in the registry record, and the statistical model for the comparison is not reported.
Precision depends on the information available in the outcome data, including the eligible denominators and how often refusal occurs. Counts and rates are necessary to understand the observed data, while an uncertainty measure helps characterize how stable an estimate may be. Neither is available for the primary endpoint in the posted record. Enrollment alone cannot supply these details, because enrollment is not the same as the outcome denominator in each period.
How should planning illustrations be read?
In general, a sample-size calculation for a future study asks how many observations might be needed to detect a specified effect under stated assumptions. The registry describes planning illustrations based on the observed effect, a two-sided significance level of 0.05, equal allocation between arms, and a normal approximation. It also says that the effect to detect is a stated fraction of the observed effect. These are planning assumptions, not evidence about the performance of this pilot. The numerical illustrations and observed effect are not reported in the registry record, so their implications cannot be assessed.
Such calculations are not observed power. In general, observed power calculated after a study using its estimated effect does not provide an independent measure of whether the result is reliable. Planning illustrations can help convey how assumptions about effect size and design influence a future sample-size target, but they do not establish an outcome or compensate for missing estimates. The record does not report the trial’s own sample-size justification.
What is not specified about the analysis?
The registry lists two outcome measures and one analysis, and identifies team-member satisfaction as a secondary outcome. It does not report the primary analysis method, whether the comparison was adjusted, how uncertainty was estimated, or whether any interim analyses occurred. No inferential method should be assumed from the endpoint being a rate. If eligible individuals contributed repeated records or if the data had other dependence structures, the appropriate analysis would depend on those details; the registry does not describe them. These omissions prevent a full assessment of whether the analysis matched the study design and data structure.
10. Multiplicity, Missing Data and Analysis Populations
The registry lists two outcome measures, including the primary palliative care refusal rate and a secondary measure concerning satisfaction among community-based palliative care team members. It lists one analysis, but does not report the analysis plan, the outcome-specific hypotheses, or whether any adjustment for multiple comparisons was used. When several outcomes are examined, the chance of a false-positive finding can increase if each is tested separately without an appropriate strategy. In general, prespecifying a primary outcome and treating secondary outcomes as supportive or exploratory can help readers distinguish confirmatory from hypothesis-generating evidence. The registry does not provide enough detail to determine how multiplicity was handled.
Missing-data procedures are not reported in the registry record. The outcome relies on electronic health records, but the record does not say how people with absent, incomplete, or unclear documentation were classified, whether eligibility status could be missing, or how missing records were handled in the denominator. Those details matter because missing outcome information can bias a rate if its occurrence is related to refusal or eligibility.
The analysis population is also not described beyond the endpoint’s eligibility criteria. The record does not state whether all eligible people were included in the primary analysis, how exclusions were defined, or whether the groups were analyzed according to a particular assignment principle. These are not details that can be inferred from the completed status or recorded enrollment. Consequently, the extent of missingness, analysis exclusions, and their potential effects on the primary comparison are not reported in the registry record.
11. Safety Results
The registry reports serious adverse events as affected participants divided by participants at risk.
| Arm | Participants with serious adverse events | Participants at risk | Percentage |
|---|---|---|---|
| Intervention Group | 0 | 111 | 0.0% |
| Control Group | 0 | 182 | 0.0% |
| Community Based Pallaitve Care Team Members | 0 | 7 | 0.0% |
Deaths
| Arm | Deaths (participants affected of at risk) |
|---|---|
| Intervention Group | 0 of 111 |
| Control Group | 0 of 182 |
| Community Based Pallaitve Care Team Members | 0 of 7 |
Other (non-serious) adverse events
Participants with at least one non-serious event at or above the registry's 0% reporting threshold.
| Arm | Participants affected of at risk |
|---|---|
| Intervention Group | 0 of 111 |
| Control Group | 0 of 182 |
| Community Based Pallaitve Care Team Members | 0 of 7 |
The adverse-event entries report zero serious adverse events, zero other adverse events, and zero deaths for the intervention group, with 111 listed as at risk. The control group has zero serious events, zero other events, and zero deaths, with 182 listed as at risk. The community-based palliative care team member group has zero serious events, zero other events, and zero deaths, with 7 listed as at risk.
These are the registry’s recorded counts. They should not be read as proof that no event occurred outside the definitions, observation periods, or reporting process used for the record. The registry does not describe the event-collection procedures, follow-up completeness, or criteria for classifying events. The control group is historical, and the team-member group is distinct in role from the eligible-member groups; these entries are not a randomized safety comparison. The zero counts do not provide evidence about the primary refusal-rate outcome, and they do not establish whether the informational intervention affected uptake.
12. What the Result Does, and Does Not, Mean
This study addresses an implementation question: whether tailored information can be used in a Medicare Advantage setting as part of efforts to address barriers to accepting community-based palliative care. The intervention is designed to give the care team informational material and tailor delivery to reflect an individual’s risk as identified by the plan’s 12-month mortality risk algorithm. The primary outcome focuses on refusal among eligible people, which is relevant to uptake at the point of decision.
What the posted record does not establish is whether the refusal rate changed. The registry does not report the relevant counts, rates, effect estimate, or uncertainty. It is therefore not possible to say whether refusal was more or less frequent during the intervention period, or how precisely any difference was estimated. No effect should be inferred from the study’s completed status or its recorded enrollment.
Even if a difference were reported, the nonrandomized historical comparison would limit causal interpretation. A before-and-after contrast can be affected by changes in the population, eligibility practices, usual care, or record keeping. The registry does not report how these possibilities were assessed. A rate difference would describe the observed comparison; by itself it would not prove that tailored information caused the difference.
The record also does not establish that any change in refusal would translate into a change in later care or outcomes. The primary measure is refusal rate, not a broader measure of patient or family experience, and the listed secondary outcome is team-member satisfaction. The record does not report results for that secondary measure either. Thus, the supported interpretation is limited to the study’s aims, design, and specified measures. Determining what happened to uptake requires outcome results; determining why it happened requires further analysis and evidence beyond the design description.
13. Why This Trial Matters Statistically
This trial is statistically informative as an example of evaluating an implementation strategy with a historical control. Such designs can test whether a process is feasible in a real care setting, but the pre/post structure makes time an important alternative explanation for observed differences. The interpretation depends not only on the outcome measure, but also on whether eligibility, refusal definitions, and documentation are comparable across the two periods.
The endpoint is a rate with a meaningful denominator: eligible people, rather than an uncontextualized count of refusals. This makes clear what the outcome is intended to measure. At the same time, a well-defined rate needs complete reporting of its numerator and denominator in each period, plus a comparison estimate and uncertainty. Those outcome details are not reported in the registry record. The record therefore illustrates the difference between specifying a useful endpoint and reporting results that allow readers to evaluate it.
The study also highlights the value of aligning timing descriptions. The endpoint specifies five-month pre-intervention and intervention periods, while the arm descriptions refer to six-month periods. Clear, consistent windows help readers understand which observations contribute to each rate and whether the groups are comparable. The registry record does not resolve the differing descriptions.
Finally, the record distinguishes a pilot’s stated aim from evidence of an effect. Planning illustrations based on an observed effect can inform future design choices, but they are not observed power and do not replace estimates of the primary outcome. Without those estimates, the statistical contribution that can be assessed is chiefly the design and measurement approach, not the magnitude or precision of an intervention effect.
14. Limitations
- The posted summary statistics are the only data these results rest on; patient-level data, full protocols and statistical analysis plans are not available.
- Recalculated results are simple, unadjusted calculations from posted summaries. They do not replace the sponsor's prespecified analysis.
The most immediate limitation for interpreting results is that the registry record does not report the primary refusal counts, rates, or a comparison estimate. It also does not report uncertainty measures, so neither the size nor precision of a possible difference can be assessed. The completed status and recorded enrollment do not fill this gap.
The nonrandomized, historical control design allows period-related differences to influence the comparison. The record does not report whether the groups were adjusted for measured characteristics or changes in care delivery. It also does not describe whether eligibility criteria and refusal documentation were applied consistently across periods. The endpoint timeframe is described as five months before and five months during intervention, while the arm descriptions refer to six-month periods; the implemented windows are not clarified.
Information about missing data and analysis populations is not reported. The record does not explain how absent or ambiguous electronic health records were handled, whether all eligible people were included, or what exclusions were applied. Statistical methods for the primary comparison, including any adjustment and uncertainty estimation, are also not reported. The number of outcome measures and analyses is listed, but the approach to multiplicity is not described.
The adverse-event counts are zero in the listed groups, but collection and reporting procedures are not described. Finally, the registry’s description of tailored information and its intended use does not establish how consistently the intervention was delivered or how recipients engaged with it. These limitations restrict assessment of both the outcome and the process that produced it.
15. Related Tutorials
16. Related Statistical Calculators
17. Sources
- ClinicalTrials.gov: Translating Data Science to Palliative Care — NCT05942040.
- Registry record last updated 2025-11-18; status last verified 2025-11.
- Results first posted 2025-11-18.
- Data retrieved from ClinicalTrials.gov on 2026-11-09.
- Group sizes, means, event counts and sponsor-reported p-values are reproduced as posted. Effect estimates, confidence intervals and p-values not attributed to the sponsor are independently calculated from the posted summary statistics.
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18. Record Summary
The registry record describes a completed, nonrandomized, parallel-group pilot of tailored information about community-based palliative care. The intervention is compared with a retrospective period in which eligible members received usual care or information. The primary endpoint is refusal rate among people eligible for the program, assessed using electronic health records. Team-member satisfaction is listed as a secondary outcome.
Enrollment is recorded as 301, and masking is listed as none. The primary timeframe specifies five months before and five months during the intervention, while the arm descriptions refer to six-month periods. The registry lists two outcome measures and one analysis. It does not report the refusal counts or rates, a primary comparison estimate, confidence interval, or p-value. Statistical methods, missing-data procedures, analysis populations, and multiplicity handling are not reported in the registry record. Adverse-event entries show zero serious events, zero other events, and zero deaths in each listed group.