Trial reportJournal of the American Geriatrics Society2011
Improving decision-making for feeding options in advanced dementia: a randomized, controlled trial.
Trial report in Journal of the American Geriatrics Society, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 90 papers, 18 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
90 citing papers in PubMed, 18 syntheses or guidelines pooled it.
- Emotional, Ethical and Cultural Challenges in Percutaneous Endoscopic Gastrostomy (PEG) Decision-Making: A Systematic Review and Meta-Synthesis.Health expectations : an international journal of public participation in health care and health policy · 2026Pooled it
- Effects of patient decision aids used pre-consult or in-consult on patient-clinician communication - secondary analysis of a systematic review with meta-analysis.BMC medical informatics and decision making · 2025Pooled it
- A systematic review on dysphagia treatments for persons living with dementia.European geriatric medicine · 2024Pooled it
- Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2024Pooled it
- Palliative Care Intervention Trials for Adults Living With Progressive Central Nervous System Diseases and Their Caregivers: A Systematic Review.Journal of pain and symptom management · 2022Pooled it
- A decision aid to support family carers of people living with dementia towards the end-of-life: Coproduction process, outcome and reflections.Health expectations : an international journal of public participation in health care and health policy · 2021Pooled it
- Palliative care interventions in advanced dementia.The Cochrane database of systematic reviews · 2021Pooled it
- Enhancing shared and surrogate decision making for people living with dementia: A systematic review of the effectiveness of interventions.Health expectations : an international journal of public participation in health care and health policy · 2021Pooled it
- Extent and Predictors of Decision Regret among Informal Caregivers Making Decisions for a Loved One: A Systematic Review.Medical decision making : an international journal of the Society for Medical Decision Making · 2020Pooled it
- Setting Priorities to Inform Assessment of Care Homes' Readiness to Participate in Healthcare Innovation: A Systematic Mapping Review and Consensus Process.International journal of environmental research and public health · 2020Pooled it
- Association of Surrogate Decision-making Interventions for Critically Ill Adults With Patient, Family, and Resource Use Outcomes: A Systematic Review and Meta-analysis.JAMA network open · 2019Pooled it
- Interventions for increasing the use of shared decision making by healthcare professionals.The Cochrane database of systematic reviews · 2018Pooled it
- Environmental and behavioural modifications for improving food and fluid intake in people with dementia.The Cochrane database of systematic reviews · 2018Pooled it
- Decision aids for people facing health treatment or screening decisions.The Cochrane database of systematic reviews · 2017Pooled it
- Palliative care interventions in advanced dementia.The Cochrane database of systematic reviews · 2016Pooled it
- Effectiveness of interventions to indirectly support food and drink intake in people with dementia: Eating and Drinking Well IN dementiA (EDWINA) systematic review.BMC geriatrics · 2016Pooled it
- Decision aids to help older people make health decisions: a systematic review and meta-analysis.BMC medical informatics and decision making · 2016Pooled it
- Tools to Promote Shared Decision Making in Serious Illness: A Systematic Review.JAMA internal medicine · 2015Pooled it
- Advance Care Planning Video Intervention Among Long-Stay Nursing Home Residents: A Pragmatic Cluster Randomized Clinical Trial.JAMA internal medicine · 2020Trial
- Trial
30 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
objectivesTo test whether a decision aid improves quality of decision-making about feeding options in advanced dementia.
designCluster randomized controlled trial.
settingTwenty-four nursing homes in North Carolina.
participantsResidents with advanced dementia and feeding problems and their surrogates.
interventionIntervention surrogates received an audio or print decision aid on feeding options in advanced dementia. Controls received usual care. MEASUREMENTS: Primary outcome was the Decisional Conflict Scale (range: 1-5) measured at 3 months; other main outcomes were surrogate knowledge, frequency of communication with providers, and feeding treatment use.
resultsTwo hundred fifty-six residents and surrogate decision-makers were recruited. Residents' average age was 85; 67% were Caucasian, and 79% were women. Surrogates' average age was 59; 67% were Caucasian, and 70% were residents' children. The intervention improved knowledge scores (16.8 vs 15.1, P < .001). After 3 months, intervention surrogates had lower Decisional Conflict Scale scores than controls (1.65 vs 1.90, P < .001) and more often discussed feeding options with a healthcare provider (46% vs 33%, P = .04). Residents in the intervention group were more likely to receive a dysphagia diet (89% vs 76%, P = .04) and showed a trend toward greater staff eating assistance (20% vs 10%, P = .08). Tube feeding was rare in both groups even after 9 months (1 intervention vs 3 control, P = .34).
conclusionA decision aid about feeding options in advanced dementia reduced decisional conflict for surrogates and increased their knowledge and communication about feeding options with providers.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.