Trial reportJournal of pain and symptom management2013
Life-sustaining treatment preferences: matches and mismatches between patients' preferences and clinicians' perceptions.
Trial report in Journal of pain and symptom management, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 1 of them a synthesis 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
18 citing papers in PubMed, 1 synthesis or guideline pooled it, 59 citations in OpenAlex.
- Pooled it
- Seriously Ill Patients' Prioritized Goals and Their Clinicians' Perceptions of Those Goals.Journal of pain and symptom management · 2022Trial
- Patient-Reported Receipt of Goal-Concordant Care Among Seriously Ill Outpatients-Prevalence and Associated Factors.Journal of pain and symptom management · 2020Trial
- Death and the Oldest Old: Attitudes and Preferences for End-of-Life Care--Qualitative Research within a Population-Based Cohort Study.PloS one · 2016Trial
- Perspectives of healthcare professionals and older patients on shared decision-making for treatment escalation planning in the acute hospital setting: a systematic review and qualitative thematic synthesis.EClinicalMedicine · 2023Article
- Palliative care and infection management at end of life in nursing homes: A descriptive survey.Palliative medicine · 2020Article
- End-of-life care preferences of the general public and recommendations of healthcare providers: a nationwide survey in Japan.BMC palliative care · 2020Article
- Facilitators and barriers to stakeholder engagement in advance care planning for older adults in community settings: a hybrid systematic review protocol.HRB open research · 2020Article
- A comparative study on decision and documentation of refraining from resuscitation in two medical home care units in Sweden.BMC palliative care · 2019Article
- Experiences with approaches to advance care planning with older people: a qualitative study among Dutch general practitioners.BMJ open · 2018Article
- Perspectives of survivors, families and researchers on key outcomes for research in acute respiratory failure.Thorax · 2018Article
- Advance care planning for patients with amyotrophic lateral sclerosis.Amyotrophic lateral sclerosis & frontotemporal degeneration · 2017Article
- Potential Influence of Advance Care Planning and Palliative Care Consultation on ICU Costs for Patients With Chronic and Serious Illness.Critical care medicine · 2016Article
- Economic Impact of an Advanced Illness Consultation Program within a Medicare Advantage Plan Population.Journal of palliative medicine · 2016Article
- Palliative Care Teams' Cost-Saving Effect Is Larger For Cancer Patients With Higher Numbers Of Comorbidities.Health affairs (Project Hope) · 2016Observational
- Patient preferences in severe COPD and asthma: a comprehensive literature review.International journal of chronic obstructive pulmonary disease · 2015Review
- Use of the Physician Orders for Life-Sustaining Treatment program for patients being discharged from the hospital to the nursing facility.Journal of palliative medicine · 2014Article
- The luck of the draw: physician-related variability in end-of-life decision-making in intensive care.Intensive care medicine · 2013Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
Abstract
contextBetter clinician understanding of patients' end-of-life treatment preferences has the potential for reducing unwanted treatment, decreasing health care costs, and improving end-of-life care.
objectivesTo investigate patient preferences for life-sustaining therapies, clinicians' accuracy in understanding those preferences, and predictors of patient preference and clinician error.
methodsThis was an observational study of 196 male veterans with chronic obstructive pulmonary disease who participated in a randomized trial. Measures included patients' preferences for mechanical ventilation (MV) and cardiopulmonary resuscitation (CPR) if needed in their current state of health, and outpatient clinicians' beliefs about those preferences.
resultsAnalyses were based on 54% of participants in the trial who had complete patient/clinician data on treatment preferences. Patients were more receptive to CPR than MV (76% vs. 61%; P<0.001). Preferences for both treatments were significantly associated with the importance patients assigned to avoiding life-sustaining therapies during the final week of life (MV: b=-0.11, P<0.001; CPR: b=-0.09, P=0.001). When responses were dichotomized (would/would not want treatment), clinicians' perceptions matched patient preferences in 75% of CPR cases and 61% of MV cases. Clinician errors increased as patients preferred less aggressive treatment (MV: b=-0.28, P<0.001; CPR: b=-0.32, P<0.001).
conclusionClinicians erred more often about patients' wishes when patients did not want treatment than when they wanted it. Treatment decisions based on clinicians' perceptions could result in costly and unwanted treatments. End-of-life care could benefit from increased clinician-patient discussion about end-of-life care, particularly if discussions included patient education about risks of treatment and allowed clinicians to form and maintain accurate impressions of patients' preferences.
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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.