Evidence map›Paper›PMID 26141307›Full record

Trial reportAmerican journal of kidney diseases : the official journal of the National Kidney Foundation2015

Advance care planning and end-of-life decision making in dialysis: a randomized controlled trial targeting patients and their surrogates.

Mi-Kyung Song, Sandra E Ward, Jason P Fine, Laura C Hanson, Feng-Chang Lin, Gerald A Hladik, Jill B Hamilton, Jessica C Bridgman

2 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in American journal of kidney diseases : the official journal of the National Kidney Foundation, 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 80 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 4 pooled it
17.5field-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.

NCT01259011 nacompletednot on this map

A Randomized Controlled Trial of SPIRIT: A Representational Intervention to Promote Preparation for End-of-Life Decision Making

TypeinterventionalSponsorUniversity of North Carolina, Chapel HillRan2010 to 2014Enrolled210ConditionsEnd Stage Renal DiseaseArmsthe SPIRIT intervention
NCT06046261 nacompletednot on this mapstarted 2022, after this paper: background citation

Exploring the Impact of " ACP Board Game for Life" on Death Preparation and Anxiety in Patients With Stage 4 and 5 Chronic Kidney Diseases: A Pilot Study

TypeinterventionalSponsorNational Cheng-Kung University HospitalRan2022 to 2023Enrolled69ConditionsChronic Kidney Disease, Chronic Renal Failure, Chronic Renal Insufficiency, End of Life CareArmsACP board game for life
3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 4 syntheses or guidelines pooled it, 181 citations in OpenAlex.

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  4. Advance care planning for haemodialysis patients.The Cochrane database of systematic reviews · 2016
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  7. Implementation of An Advance Care Planning Intervention in Dialysis Clinics.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2025
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20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Mi-Kyung SongSchool of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: songm@email.unc.edu.
Sandra E WardSchool of Nursing, University of Wisconsin-Madison, Madison, WI.
Jason P FineSchool of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Laura C HansonSchool of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Feng-Chang LinSchool of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Gerald A HladikUniversity of North Carolina Kidney Center, Chapel Hill, NC.
Jill B HamiltonSchool of Nursing, Johns Hopkins University, Baltimore, MD.
Jessica C BridgmanSchool of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC.
University of North Carolina at Chapel Hill · USJohns Hopkins University · USUniversity of Wisconsin–Madison · US

Funding

Representational Intervention to Promote End-of-Life Decision-Making PreparationR01NR011464 · NINR · UNIV OF NORTH CAROLINA CHAPEL HILL · PI SONG, MI-KYUNG · 2009 to 2013
$3.1M
NINR NIH HHS R01 NR011464NINR NIH HHS R01NR011464
6 · The paper itself

Abstract

backgroundFew trials have examined long-term outcomes of advance care planning (ACP) interventions. We examined the efficacy of an ACP intervention on preparation for end-of-life decision making for dialysis patients and surrogates and for surrogates' bereavement outcomes. STUDY

designA randomized trial compared an ACP intervention (Sharing Patient's Illness Representations to Increase Trust [SPIRIT]) to usual care alone, with blinded outcome assessments. SETTING &

participants420 participants (210 dyads of prevalent dialysis patients and their surrogates) from 20 dialysis centers.

interventionEvery dyad received usual care. Those randomly assigned to SPIRIT had an in-depth ACP discussion at the center and a follow-up session at home 2 weeks later. OUTCOMES & MEASUREMENTS: PRIMARY OUTCOMES: preparation for end-of-life decision making, assessed for 12 months, included dyad congruence on goals of care at end of life, patient decisional conflict, surrogate decision-making confidence, and a composite of congruence and surrogate decision-making confidence. SECONDARY OUTCOMES: bereavement outcomes, assessed for 6 months, included anxiety, depression, and posttraumatic distress symptoms completed by surrogates after patient death.

resultsPRIMARY OUTCOMES: adjusting for time and baseline values, dyad congruence (OR, 1.89; 95% CI, 1.1-3.3), surrogate decision-making confidence (β=0.13; 95% CI, 0.01-0.24), and the composite (OR, 1.82; 95% CI, 1.0-3.2) were better in SPIRIT than controls, but patient decisional conflict did not differ between groups (β=-0.01; 95% CI, -0.12 to 0.10). SECONDARY OUTCOMES: 45 patients died during the study. Surrogates in SPIRIT had less anxiety (β=-1.13; 95% CI, -2.23 to -0.03), depression (β=-2.54; 95% CI, -4.34 to -0.74), and posttraumatic distress (β=-5.75; 95% CI, -10.9 to -0.64) than controls. LIMITATIONS: Study was conducted in a single US region.

conclusionsSPIRIT was associated with improvements in dyad preparation for end-of-life decision making and surrogate bereavement outcomes.

Indexed as

Advance Care PlanningDecision MakingRenal DialysisAdultAgedAnxietyBereavementConflict, PsychologicalDepressionFemaleHumansKidney Failure, ChronicMaleMiddle AgedPatient Care PlanningPatient ParticipationAdvance care planning (ACP)advanced kidney diseasebereavementdeathdyad congruenceemotional distressend-of-life decision makingend-stage renal disease (ESRD)hemodialysislife-sustaining treatmentmedical decisionpatient education interventionpatient-surrogate dyadrandomized controlled trial (RCT)surrogate decision makertreatment options

Identifiers

PMID26141307
PMCPMC5972830
OpenAlexW1961992809

What OpenQuestion holds

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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.