Trial reportSimulation in healthcare : journal of the Society for Simulation in Healthcare2014
Using simulation to assess the influence of race and insurer on shared decision making in periviable counseling.
Trial report in Simulation in healthcare : journal of the Society for Simulation in Healthcare, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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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
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 26 citations in OpenAlex.
- Counselling about the Risk of Preterm Delivery: A Systematic Review.BioMed research international · 2017Pooled it
- Bias and Disparities in Neonatal End-of-Life Care.NeoReviews · 2025Article
- Development of a checklist for evaluation of shared decision-making in consultation for extremely preterm delivery.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Social Vulnerability and Pregnancy Option Counseling in the Setting of Periviable Delivery.Journal of clinical medicine · 2025Article
- Decision making at extreme prematurity: Innovation in clinician education.Seminars in perinatology · 2022Article
- User-testing of a decision-support tool for parents facing threatened periviable delivery: The Periviable GOALS decision aid.Patient education and counseling · 2021Article
- Diverse perspectives on death, disability, and quality of life: an exploratory study of racial differences in periviable decision-making.Journal of perinatology : official journal of the California Perinatal Association · 2021Article
- Virtual Antenatal Encounter and Standardized Simulation Assessment (VANESSA): Pilot Study.JMIR serious games · 2018Article
- Shared Decision Making With Vulnerable Populations in the Emergency Department.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2016Article
- The 2016 Academic Emergency Medicine Consensus Conference, "Shared Decision Making in the Emergency Department: Development of a Policy-relevant Patient-centered Research Agenda" Diagnostic Testing Breakout Session Report.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2016Article
- A Pilot Study of Neonatologists' Decision-Making Roles in Delivery Room Resuscitation Counseling for Periviable Births.AJOB empirical bioethics · 2016Article
- Offering induction of labor for 22-week premature rupture of membranes: a survey of obstetricians.Journal of perinatology : official journal of the California Perinatal Association · 2015Article
- Comparing obstetricians' and neonatologists' approaches to periviable counseling.Journal of perinatology : official journal of the California Perinatal Association · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
introductionSociodemographic differences have been observed in the treatment of extremely premature (periviable) neonates, but the source of this variation is not well understood. We assessed the feasibility of using simulation to test the effect of maternal race and insurance status on shared decision making (SDM) in periviable counseling.
methodsWe conducted a 2 × 2 factorial simulation experiment in which obstetricians and neonatologists counseled 2 consecutive standardized patients diagnosed with ruptured membranes at 23 weeks, counterbalancing race (black/white) and insurance status using random permutation. We assessed verisimilitude of the simulation in semistructured debriefing interviews. We coded physician communication related to resuscitation, mode of delivery, and steroid decisions using a 9-point SDM coding framework and then compared communication scores by standardized patient race and insurer using analysis of variance.
resultsSixteen obstetricians and 15 neonatologists participated; 71% were women, 84% were married, and 75% were parents; 91% of the physicians rated the simulation as highly realistic. Overall, SDM scores were relatively high, with means ranging from 6.4 to 7.9 (of 9). There was a statistically significant interaction between race and insurer for SDM related to steroid use and mode of delivery (P < 0.01 and P = 0.01, respectively). Between-group comparison revealed nonsignificant differences (P = <0.10) between the SDM scores for privately insured black patients versus privately insured white patients, Medicaid-insured white patients versus Medicaid-insured black patients, and privately insured black patients versus Medicaid-insured black patients.
conclusionsThis study confirms that simulation is a feasible method for studying sociodemographic effects on periviable counseling. Shared decision making may occur differentially based on patients' sociodemographic characteristics and deserves further study.
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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.