Evidence map›Paper›PMID 26378963›Full record

Trial reportAmerican journal of respiratory and critical care medicine2016

Randomized Trial of Communication Facilitators to Reduce Family Distress and Intensity of End-of-Life Care.

J Randall Curtis, Patsy D Treece, Elizabeth L Nielsen, Julia Gold, Paul S Ciechanowski, Sarah E Shannon, Nita Khandelwal, Jessica P Young, Ruth A Engelberg

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

Trial report in American journal of respiratory and critical care medicine, 2016. 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 173 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
173citing papers in PubMed, 12 pooled it
32.8field-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.

NCT02875912 nacompletednot on this map

PROSPECTIVE EVALUATION OF FAMILY CARE RITUALS IN THE ICU AND VALIDATION OF THE END-of-Life ScorING-System (ENDING-S), a Multicenter, Multinational Trial

TypeinterventionalSponsorBrown UniversityRan2015 to 2017Enrolled452ConditionsStress Disorders, Post-Traumatic, Depression, AnxietyArmsFamily Care Rituals
NCT04476914 completednot on this mapstarted 2020, after this paper: background citation

Psychological Distress Symptoms in Family Members of Patients With COVID-19 Respiratory Failure in Intensive Care Units

TypeobservationalSponsorUniversity of Colorado, DenverRan2020 to 2021Enrolled330ConditionsRespiratory Failure, SARS-CoV 2, Corona Virus Infection, Post Intensive Care Unit Syndrome
3 · Its place in the literature

Who cites it

173 citing papers in PubMed, 12 syntheses or guidelines pooled it, 373 citations in OpenAlex.

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  12. Family Support Strategies During Intensive Care Unit: A Systematic Review.Inquiry : a journal of medical care organization, provision and financing
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113 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors at 5 institutions in 4 countries.

J Randall Curtis1 Cambia Palliative Care Center of Excellence and Division of Pulmonary and Critical Care.
Patsy D Treece1 Cambia Palliative Care Center of Excellence and Division of Pulmonary and Critical Care.
Elizabeth L Nielsen1 Cambia Palliative Care Center of Excellence and Division of Pulmonary and Critical Care.
Julia Gold3 School of Law.
Paul S Ciechanowski4 Department of Psychiatry and Behavioral Sciences, and.
Sarah E Shannon2 Department of Biobehavioral Nursing and Health Systems, School of Nursing.
Nita Khandelwal5 Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
Jessica P Young1 Cambia Palliative Care Center of Excellence and Division of Pulmonary and Critical Care.
Ruth A Engelberg1 Cambia Palliative Care Center of Excellence and Division of Pulmonary and Critical Care.
Cambia · AUCollege of Law · LVInstitute of Behavioral Sciences · JPNeurobehavioral Systems · USUniversity of Washington · US

Funding

Randomized trial of an interdisciplinary communication intervention to improve paR01NR005226 · NINR · UNIVERSITY OF WASHINGTON · PI CURTIS, J RANDALL, ENGELBERG, RUTH ANN · 1999 to 2012
$6.7M
NINR NIH HHS R01 NR005226NINR NIH HHS R01 NR05226
6 · The paper itself

Abstract

rationaleCommunication with family of critically ill patients is often poor and associated with family distress.

objectivesTo determine if an intensive care unit (ICU) communication facilitator reduces family distress and intensity of end-of-life care.

methodsWe conducted a randomized trial at two hospitals. Eligible patients had a predicted mortality greater than or equal to 30% and a surrogate decision maker. Facilitators supported communication between clinicians and families, adapted communication to family needs, and mediated conflict. MEASUREMENTS AND MAIN

resultsOutcomes included depression, anxiety, and post-traumatic stress disorder (PTSD) among family 3 and 6 months after ICU and resource use. We identified 488 eligible patients and randomized 168. Of 352 eligible family members, 268 participated (76%). Family follow-up at 3 and 6 months ranged from 42 to 47%. The intervention was associated with decreased depressive symptoms at 6 months (P = 0.017), but there were no significant differences in psychological symptoms at 3 months or anxiety or PTSD at 6 months. The intervention was not associated with ICU mortality (25% control vs. 21% intervention; P = 0.615) but decreased ICU costs among all patients (per patient: $75,850 control, $51,060 intervention; P = 0.042) and particularly among decedents ($98,220 control, $22,690 intervention; P = 0.028). Among decedents, the intervention reduced ICU and hospital length of stay (28.5 vs. 7.7 d and 31.8 vs. 8.0 d, respectively; P < 0.001).

conclusionsCommunication facilitators may be associated with decreased family depressive symptoms at 6 months, but we found no significant difference at 3 months or in anxiety or PTSD. The intervention reduced costs and length of stay, especially among decedents. This is the first study to find a reduction in intensity of end-of-life care with similar or improved family distress. Clinical trial registered with www.clinicaltrials.gov (NCT 00720200).

Indexed as

Professional-Family RelationsAged, 80 and overCommunicationCosts and Cost AnalysisDecision MakingDepressionFamilyFemaleFollow-Up StudiesHumansIntensive Care UnitsLength of StayMaleMiddle AgedNegotiatingPalliative Carecommunicationcritical carefamilypalliative carerandomized trial

Identifiers

PMID26378963
PMCPMC4731711
OpenAlexW2128195581

What OpenQuestion holds

Textmetadata
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.