Evidence map›Paper›PMID 28865870›Full record

ArticleJournal of pain and symptom management2018

Outcomes That Define Successful Advance Care Planning: A Delphi Panel Consensus.

Rebecca L Sudore, Daren K Heyland, Hillary D Lum, Judith A C Rietjens, Ida J Korfage, Christine S Ritchie, Laura C Hanson, Diane E Meier, Steven Z Pantilat, Karl Lorenz and 5 more

2 registry-linked trialsAbstract readConsensus Statement
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of pain and symptom management, 2018. 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 161 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
161citing papers in PubMed, 7 pooled it
–field-weighted citation impact
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.

NCT04308356 completednot on this mapstarted 2020, after this paper: background citation

"What if we Talked About it…" Identification of Cancer Patients Taking up a Proposal for Discussions Dedicated to Anticipating Preferences of Care in the Event of Aggravation (DDA): Prospective Cohort Intervention Study Using a Mixed Methodology

TypeobservationalSponsorAssistance Publique - Hôpitaux de ParisRan2020 to 2024Enrolled71ConditionsNeoplasm Metastasis, Locoregional Neoplasm, Advanced CancerArmsDedicated Discussions on Anticipating preferences of care in the event of Aggravation (DDA), Autonomy Preference Index (API ) questionnaire - Information, anxiety and depression (HADS) questionnaire
NCT04912245 nacompletednot on this mapstarted 2021, after this paper: background citation

A Telehealth Advance Care Planning Intervention in Those With Mild Cognitive Impairment or Unrecognized Dementia (Tele Voice)

TypeinterventionalSponsorWake Forest University Health SciencesRan2021 to 2022Enrolled152ConditionsAdvance Care Planning, Telemedicine, Mild Cognitive Impairment, Unrecognized DementiaArmsTelehealth visit
3 · Its place in the literature

Who cites it

161 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. [Evidence on Advance Care Planning for People with Dementia - A Systematic Review (2017-2023)].Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)) · 2026
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101 more citing papers are in PubMed but not listed here.

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

15 authors.

Rebecca L SudoreDivision of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA; Veteran Affairs Medical Center, San Francisco, California, USA. Electronic address: Rebecca.sudore@ucsf.edu.
Daren K HeylandDepartment of Critical Care Medicine, Queen's University, Clinical Evaluation Research Unit, Kingston General Hospital, Ontario, Canada.
Hillary D LumVeteran Affairs Eastern Colorado Geriatrics Research Education and Clinical Center (GRECC), Denver, Colorado, USA; Department of Geriatric Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado, USA.
Judith A C RietjensDepartment of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
Ida J KorfageDepartment of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
Christine S RitchieDivision of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA.
Laura C HansonDivision of Geriatric Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Diane E MeierBrookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Steven Z PantilatPalliative Care Program, Division of Hospital Medicine, Department of Medicine, University of California, San Francisco, California, USA.
Karl LorenzVeteran Affairs Medical Center, Palo Alto, California, USA; Stanford University, Palo Alto, California, USA.
Michelle HowardDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.
Michael J GreenDepartments of Humanities and Medicine, Penn State College of Medicine, Hershey, Pennsylvania.
Jessica E SimonDepartments of Oncology, Community Health Sciences and Medicine, University of Calgary, Calgary, Alberta, Canada.
Mariko A FeuzDivision of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA; Veteran Affairs Medical Center, San Francisco, California, USA.
John J YouDepartment of Medicine, McMaster University, Hamilton, Ontario, Canada; Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada.

Funding

VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 2013 to 2026
$19.9M
Refinement and Expansion of the Palliative Care Research Cooperative Group (PCRC)U24NR014637 · NINR · DUKE UNIVERSITY · PI KUTNER, JEAN S, POLLAK, KATHRYN I · 2013 to 2017
$9.6M
Palliative Care Research Cooperative Group (PCRC): Refinement and ExpansionU2CNR014637 · NINR · UNIVERSITY OF COLORADO DENVER · PI RITCHIE, CHRISTINE S · 2018 to 2022
$8.6M
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
Mentoring Researchers in Advance Care Planning for Underrepresented Older Adults at Risk for Alzheimer’s Disease and Related Dementias and Their CaregiversK24AG054415 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI REBECCA L SUDORE · 2017 to 2026
$1.7M
Refining an Advance Care Planning Group Visit intervention – a novel intervention to engage older adults in advance care planningK76AG054782 · NIA · UNIVERSITY OF COLORADO DENVER · PI LUM, HILLARY · 2016 to 2019
$864k
NIA NIH HHS K24 AG054415NIA NIH HHS K76 AG054782NIA NIH HHS P30 AG044281NIA NIH HHS R01 AG045043NINR NIH HHS U24 NR014637NINR NIH HHS U2C NR014637
6 · The paper itself

Abstract

contextStandardized outcomes that define successful advance care planning (ACP) are lacking.

objectiveThe objective of this study was to create an Organizing Framework of ACP outcome constructs and rate the importance of these outcomes.

methodsThis study convened a Delphi panel consisting of 52 multidisciplinary, international ACP experts including clinicians, researchers, and policy leaders from four countries. We conducted literature reviews and solicited attendee input from five international ACP conferences to identify initial ACP outcome constructs. In five Delphi rounds, we asked panelists to rate patient-centered outcomes on a seven-point "not-at-all" to "extremely important" scale. We calculated means and analyzed panelists' input to finalize an Organizing Framework and outcome rankings.

resultsOrganizing Framework outcome domains included process (e.g., attitudes), actions (e.g., discussions), quality of care (e.g., satisfaction), and health care (e.g., utilization). The top five outcomes included 1) care consistent with goals, mean 6.71 (±SD 0.04); 2) surrogate designation, 6.55 (0.45); 3) surrogate documentation, 6.50 (0.11); 4) discussions with surrogates, 6.40 (0.19); and 5) documents and recorded wishes are accessible when needed 6.27 (0.11). Advance directive documentation was ranked 10th, 6.01 (0.21). Panelists raised caution about whether "care consistent with goals" can be reliably measured.

conclusionA large, multidisciplinary Delphi panel developed an Organizing Framework and rated the importance of ACP outcome constructs. Top rated outcomes should be used to evaluate the success of ACP initiatives. More research is needed to create reliable and valid measurement tools for the highest rated outcomes, particularly "care consistent with goals."

Indexed as

Advance Care PlanningDelphi TechniqueHumansOutcome Assessment, Health CareAdvance care planningconsensusDelphi techniqueoutcome measures

Identifiers

PMID28865870
PMCPMC5794507

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.