Evidence map›Paper›PMID 28631959›Full record

ArticleAmyotrophic lateral sclerosis & frontotemporal degeneration2017

Advance care planning for patients with amyotrophic lateral sclerosis.

Benjamin H Levi, Zachary Simmons, Courtney Hanna, Allyson Brothers, Erik Lehman, Elana Farace, Megan Bain, Renee Stewart, Michael J Green

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Amyotrophic lateral sclerosis & frontotemporal degeneration, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
4.2field-weighted citation impact, top 6% 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

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.

  1. Decision coaching for people making healthcare decisions.The Cochrane database of systematic reviews · 2021
    Pooled it
  2. Trial
  3. Trial
  4. Trial
  5. Article
  6. Article
  7. Article
  8. Advance Care Planning in Neurodegenerative Disorders: A Scoping Review.International journal of environmental research and public health · 2022
    Article
  9. Article
  10. Article
  11. Article
  12. 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

9 authors at 3 institutions in 1 country.

Benjamin H Levia Department of Humanities & Pediatrics , Penn State College of Medicine , Hershey , PA , USA.
Zachary Simmonsb Department of Neurology , Penn State College of Medicine, ALS Clinic and Research Center , Hershey , PA , USA.
Courtney Hannac Penn State College of Medicine , Hershey , PA , USA.
Allyson Brothersd Human Development and Family Studies , Colorado State University , Fort Collins , CO , USA.
Erik Lehmane Department of Public Health Sciences , Penn State College of Medicine , Hershey , PA , USA.
Elana Faracee Department of Public Health Sciences , Penn State College of Medicine , Hershey , PA , USA.
Megan Bainf Department of Humanities , Penn State College of Medicine , Hershey , PA , USA , and.
Renee Stewartf Department of Humanities , Penn State College of Medicine , Hershey , PA , USA , and.
Michael J Greeng Department of Humanities & Medicine , Penn State College of Medicine , Hershey , PA , USA.
Penn State Milton S. Hershey Medical Center · USPennsylvania State University · USColorado State University · US

Funding

A Computer-Based Decision Aid for Advance Care PlanningR21NR008539 · NINR · PENNSYLVANIA STATE UNIV HERSHEY MED CTR · PI GREEN, MICHAEL J. · 2003 to 2004
$449k
NINR NIH HHS R21 NR008539
6 · The paper itself

Abstract

purposeTo determine whether an advance care planning (ACP) decision-aid could improve communication about end-of-life treatment wishes between patients with amyotrophic lateral sclerosis (ALS) and their clinicians.

methodsForty-four patients with ALS (>21, English-speaking, without dementia) engaged in ACP using an interactive computer based decision-aid. Before participants completed the intervention, and again three months later, their clinicians reviewed three clinical vignettes, and made treatment decisions (n = 18) for patients. After patients indicated their agreement with the team's decisions, concordance was calculated.

resultsThe mean concordance between patient wishes and the clinical team decisions was significantly higher post-intervention (post = 91.9%, 95% CI = 87.8, 96.1, vs. pre = 52.4%, 95% CI = 41.9, 62.9; p <0.001). Clinical team members reported greater confidence that their decisions accurately represented each patient's wishes post-intervention (mean = 6.5) compared to pre-intervention (mean = 3.3, 1 = low, 10 = high, p <0.001). Patients reported high satisfaction (mean = 26.4, SD = 3.2; 6 = low, 30 = high) and low decisional conflict (mean = 28.8, SD = 8.2; 20 = low, 80 = high) with decisions about end-of-life care, and high satisfaction with the decision-aid (mean = 52.7, SD = 5.7, 20 = low, 60 = high). Patient knowledge regarding ACP increased post-intervention (pre = 47.8% correct responses vs. post = 66.3%; p <0.001) without adversely affecting patient anxiety or self-determination.

conclusionA computer based ACP decision-aid can significantly improve clinicians' understanding of ALS patients' wishes with regard to end-of-life medical care.

Indexed as

Advance Care PlanningDecision MakingPatient SatisfactionPhysician-Patient RelationsAdultAgedAmyotrophic Lateral SclerosisFemaleFollow-Up StudiesHumansMaleMiddle AgedTerminal CareAdvance care planningadvance directivedecision-aidend of lifeethicsliving willsurrogate decision-making

Identifiers

PMID28631959
PMCPMC5943705
OpenAlexW2593286077

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.