Trial reportJournal of palliative medicine2018
Concordance between Goals of Care and Treatment Decisions for Persons with Dementia.
Trial report in Journal of palliative medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01565642 (Goals of Care), which is not on this map. Cited by 29 papers, 1 of them a synthesis that pooled 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.
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.
Goals of Care: A Nursing Home Trial of Decision Support for Advanced Dementia
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Timing of Goals of Care Discussions in Nursing Homes: A Systematic Review.Journal of the American Medical Directors Association · 2023Pooled it
- Triggered Palliative Care for Late-Stage Dementia: A Pilot Randomized Trial.Journal of pain and symptom management · 2019Trial
- Concordance Between Proxy Level of Care Preference and Advance Directives Among Nursing Home Residents With Advanced Dementia: A Cluster Randomized Clinical Trial.Journal of pain and symptom management · 2019Trial
- A Retrospective National Cohort Study of Trends in Mechanical Ventilation Among Veterans Living With Dementia, 2010-2019.Journal of the American Geriatrics Society · 2026Article
- Using novel natural language processing approaches to examine age-friendly communication about nursing Nome residents with dementia.The Gerontologist · 2026Article
- Patient-Centered Measures of Goal Concordance in Geriatrics and Palliative Care: A Scoping Review.JAMA network open · 2025Article
- Knowledge, attitudes, and representations of caregivers of individuals with major neurocognitive disorders regarding palliative and end-of-life care: a narrative literature review.BMC palliative care · 2025Review
- Differences in Timely Goals of Care Discussions in Nursing Homes Among Black Residents.The American journal of hospice & palliative care · 2025Article
- Article
- Interventions and Predictors of Transition to Hospice for People Living With Dementia: An Integrative Review.The Gerontologist · 2025Review
- Article
- Development of a predictive model for loss of functional and cognitive abilities in long-term care home residents: a protocol.BMJ open · 2025Article
- A Pragmatic Approach to Identifying Goal-Concordant Care for Nursing Home Residents With Alzheimer's Disease or Related Dementias.Journal of the American Medical Directors Association · 2024Article
- Achieving goal-concordant care: Formal and informal advance care planning for White, Black, and Hispanic older adults.Journal of the American Geriatrics Society · 2024Article
- A Personalized and Interactive Web-Based Advance Care Planning Intervention for Older Adults (Koda Health): Pilot Feasibility Study.JMIR aging · 2024Article
- Measuring the Use of End-of-Life Symptom Relief Medications in Long-Term Care Homes-a Qualitative Study.Canadian geriatrics journal : CGJ · 2024Article
- Electronic health record (EHR)-based PROMIS measures among neurology clinic decedents and survivors: a retrospective cohort analysis.Health and quality of life outcomes · 2023Article
- Nursing home infection control strategies during the COVID-19 pandemic.Journal of the American Geriatrics Society · 2023Article
- The goals of care in acute setting for geriatric patients in case of a hip fracture.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Accountable care organizations and use of surgery among patients with Alzheimer disease and related dementias.The American journal of managed care · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
backgroundNursing home (NH) residents with dementia experience high rates of intensive treatment near the end of life. Limited research examines whether treatment is concordant with goals of care (GOC).
objectivesWe analyzed data from the GOC trial to describe family decision makers' preferred GOC and perceptions of goal-concordant care for NH residents with late-stage dementia We compared subsequent treatment orders when families chose a primary goal of comfort versus other goals.
designWe performed a secondary analysis of data from baseline and 9-month family decision-maker interviews and chart reviews. SETTING AND
participantsA total of 302 dyads of NH residents and family decision makers in 22 North Carolina NHs were enrolled. MEASUREMENTS: In baseline and follow-up interviews, families reported on their and NH staff's primary GOC, and perceived prognosis and goal-concordant care. Chart reviews provided data on treatment orders, hospital transfers, and hospice, which were compared after selection of a primary goal of comfort versus other goals.
resultsFamily chose comfort as the primary goal for 66% of residents at baseline, and for nearly 80% by 9 months or death. At baseline, 49% perceived concordance with NH staff on the primary goal, and 69% at follow-up. In multivariate models, choice of comfort as the primary goal, versus other goals, was associated with half as many hospital transfers (0.11 vs. 0.25/90 person-days, confidence interval [-0.2 to -0.01]), but not with hospice or treatment orders.
conclusionsMost families chose comfort as the primary GOC. Further research is needed to translate this preference into comfort-focused treatment plans for late-stage dementia. Clinicaltrials.gov : NCT01565642 (3/26/12).
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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.