Evidence map›Paper›PMID 24768595›Full record

Trial reportJournal of pain and symptom management2014

A study to improve communication between clinicians and patients with advanced heart failure: methods and challenges behind the working to improve discussions about defibrillator management trial.

Nathan E Goldstein, Jill Kalman, Jean S Kutner, Erik K Fromme, Mathew D Hutchinson, Hannah I Lipman, Daniel D Matlock, Keith M Swetz, Rachel Lampert, Omarys Herasme and 1 more

Open access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of pain and symptom management, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.

  1. Pooled it
  2. Symptom prevalence in patients with advanced heart failure and its association with quality of life and activities of daily living.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2025
    Trial
  3. Trial
  4. Improving Communication in Heart Failure Patient Care.Journal of the American College of Cardiology · 2019
    Trial
  5. Trial
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Review
  12. Article
  13. Review
  14. Review
  15. Review
  16. Review
  17. Palliative care and decision making in advanced heart failure.Current treatment options in cardiovascular medicine · 2015
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 8 institutions in 1 country.

Nathan E GoldsteinBrookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA; James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA. Electronic address: nathan.goldstein@mssm.edu.
Jill KalmanDivision of Cardiology, Samuel Bronfman Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Jean S KutnerDivision of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Erik K FrommeDepartments of Medicine, Radiation Medicine, and Nursing, Oregon Health Sciences University, Portland, Oregon, USA.
Mathew D HutchinsonCardiovascular Division, Department of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Hannah I LipmanDivisions of Geriatrics and Cardiology, Montefiore Medical Center, Bronx, New York, USA; The Montefiore-Einstein Center for Bioethics, Montefiore Medical Center, Bronx, New York, USA.
Daniel D MatlockDivision of General Internal Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Keith M SwetzDivision of General Internal Medicine, Department of Medicine, Section of Palliative Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Rachel LampertSection of Cardiology, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA.
Omarys HerasmeBrookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
R Sean MorrisonBrookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA; James J. Peters Veterans Affairs Medical Center, Bronx, New York, USA.
Icahn School of Medicine at Mount Sinai · USUniversity of Colorado Denver · USAlbert Einstein College of Medicine · USJames J. Peters VA Medical Center · USMayo Clinic · USOregon Health & Science University · USUniversity of Pennsylvania · USYale University · US

Funding

Residing in the Community with Dementia at the End of Life: Understanding Hospice Use and Residential SettingP30AG028741 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI R. Sean Morrison · 2010 to 2026
$21.9M
An Intervention to Improve ICD Deactivation ConversationsR01HL102084 · NHLBI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI GOLDSTEIN, NATHAN E · 2011 to 2015
$3.1M
Implanted Defibrillators and Older Adults: A Model of Decisions and TechnologiesK23AG040696 · NIA · UNIVERSITY OF COLORADO DENVER · PI MATLOCK, DANIEL D · 2011 to 2015
$716k
NHLBI NIH HHS R01 HL102084NHLBI NIH HHS R01HL102084NIA NIH HHS K23 AG040696NIA NIH HHS P30 AG028741
6 · The paper itself

Abstract

We report the challenges of the Working to Improve Discussions About Defibrillator Management trial, our novel, multicenter trial aimed at improving communication between cardiology clinicians and their patients with advanced heart failure (HF) who have implantable cardioverter defibrillators (ICDs). The study objectives are (1) to increase ICD deactivation conversations, (2) to increase the number of ICDs deactivated, and (3) to improve psychological outcomes in bereaved caregivers. The unit of randomization is the hospital, the intervention is aimed at HF clinicians, and the patient and caregiver are the units of analysis. Three hospitals were randomized to usual care and three to intervention. The intervention consists of an interactive educational session, clinician reminders, and individualized feedback. We enroll patients with advanced HF and their caregivers, and then we regularly survey them to evaluate whether the intervention has improved communication between them and their HF providers. We encountered three implementation barriers. First, there were institutional review board concerns at two sites because of the palliative nature of the study. Second, we had difficulty in creating entry criteria that accurately identified an HF population at high risk of dying. Third, we had to adapt our entry criteria to the changing landscape of ventricular assist devices and cardiac transplant eligibility. Here we present our novel solutions to the difficulties we encountered. Our work has the ability to enhance conduct of future studies focusing on improving care for patients with advanced illness.

Indexed as

CommunicationDefibrillators, ImplantablePhysician-Patient RelationsBereavementCaregiversEthics Committees, ResearchHeart FailureHospitalsHumansPalliative CarecommunicationHeart failureinterventionIRBmethodspalliative carerandomized controlled trial

Identifiers

PMID24768595
PMCPMC4205212
OpenAlexW2001279773

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.