Evidence map›Paper›PMID 25985438›Full record

SynthesisJAMA internal medicine2015

Tools to Promote Shared Decision Making in Serious Illness: A Systematic Review.

C Adrian Austin, Dinushika Mohottige, Rebecca L Sudore, Alexander K Smith, Laura C Hanson

2 registry-linked trialsOpen access · greenAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in JAMA internal medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 130 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
130citing papers in PubMed, 10 pooled it
26.1field-weighted citation impact, top 1% 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.

NCT03632850 completednot on this mapstarted 2019, after this paper: background citation

Shared Decision-making: Investigating the Potential of an Interactive, Web-Based, Information Tool for People With Advanced Pancreatic Cancer

TypeobservationalSponsorBournemouth UniversityRan2019 to 2021Enrolled34ConditionsAdvanced Pancreatic CancerArmsweb-based interactive tool
NCT03649191 nacompletednot on this mapstarted 2018, after this paper: background citation

Improving Advance Care Planning for Frail, Elderly Residents in Canadian Nursing Homes: A Subproject of the BABEL Study (Better tArgetting, Better Outcomes for Frail ELderly Patients)

TypeinterventionalSponsorUniversity of ManitobaRan2018 to 2020Enrolled713ConditionsNursing Homes, Aged, Frail Elderly Syndrome, DementiaArmsThe BABEL Approach to Advance Care Planning in Nursing Homes, Control group Advance Care Planning
3 · Its place in the literature

Who cites it

130 citing papers in PubMed, 10 syntheses or guidelines pooled it, 284 citations in OpenAlex.

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  17. Family Caregivers' Characterization of Conversations Following an ACP Event.The American journal of hospice & palliative care · 2018
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70 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 4 institutions in 1 country.

C Adrian AustinCenter for Aging and Health, Division of Geriatrics, University of North Carolina, Chapel Hill.
Dinushika MohottigeDepartment of Medicine, Duke University, Durham, North Carolina.
Rebecca L SudoreDivision of Geriatrics, Department of Medicine, University of California, San Francisco4San Francisco Veterans Affairs Medical Center, San Francisco, California.
Alexander K SmithDivision of Geriatrics, Department of Medicine, University of California, San Francisco4San Francisco Veterans Affairs Medical Center, San Francisco, California.
Laura C HansonCenter for Aging and Health, Division of Geriatrics, University of North Carolina, Chapel Hill5Palliative Care Program, University of North Carolina, Chapel Hill.
University of North Carolina at Chapel Hill · USDuke University · USSan Francisco VA Medical Center · USUniversity of California, San Francisco · US

Funding

Improving advance care planning for seniors at risk for Alzheimers disease and related dementias and their caregiversR01AG045043 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI SUDORE, REBECCA L · 2013 to 2017
$3.2M
Goals of Care: A Nursing Home Trial of Decision Support for Advanced DementiaR01AG037483 · NIA · UNIV OF NORTH CAROLINA CHAPEL HILL · PI HANSON, LAURA C · 2011 to 2015
$2.6M
P0045982 Late Life Disability: Epidemiology, Symptoms, Quality of LifeK23AG040772 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SMITH, ALEXANDER KELIIMOEANU · 2012 to 2017
$756k
NIA NIH HHS K23 AG040772NIA NIH HHS R01 AG037483NIA NIH HHS R01AG037483NIA NIH HHS R01 AG045043
6 · The paper itself

Abstract

importanceSerious illness impairs function and threatens survival. Patients facing serious illness value shared decision making, yet few decision aids address the needs of this population.

objectiveTo perform a systematic review of evidence about decision aids and other exportable tools that promote shared decision making in serious illness, thereby (1) identifying tools relevant to the treatment decisions of seriously ill patients and their caregivers, (2) evaluating the quality of evidence for these tools, and (3) summarizing their effect on outcomes and accessibility for clinicians. EVIDENCE REVIEW: We searched PubMed, CINAHL, and PsychInfo from January 1, 1995, through October 31, 2014, and identified additional studies from reference lists and other systematic reviews. Clinical trials with random or nonrandom controls were included if they tested print, video, or web-based tools for advance care planning (ACP) or decision aids for serious illness. We extracted data on the study population, design, results, and risk for bias using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) criteria. Each tool was evaluated for its effect on patient outcomes and accessibility.

findingsSeventeen randomized clinical trials tested decision tools in serious illness. Nearly all the trials were of moderate or high quality and showed that decision tools improve patient knowledge and awareness of treatment choices. The available tools address ACP, palliative care and goals of care communication, feeding options in dementia, lung transplant in cystic fibrosis, and truth telling in terminal cancer. Five randomized clinical trials provided further evidence that decision tools improve ACP documentation, clinical decisions, and treatment received. CONCLUSIONS AND RELEVANCE: Clinicians can access and use evidence-based tools to engage seriously ill patients in shared decision making. This field of research is in an early stage; future research is needed to develop novel decision aids for other serious diagnoses and key decisions. Health care delivery organizations should prioritize the use of currently available tools that are evidence based and effective.

Indexed as

Decision MakingCatastrophic IllnessCritical IllnessHumansRandomized Controlled Trials as Topic

Identifiers

PMID25985438
PMCPMC4794743
OpenAlexW2149566104

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

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.