ReviewThe Lancet. Respiratory medicine2019
Pragmatic methods to avoid intensive care unit admission when it does not align with patient and family goals.
Review in The Lancet. Respiratory medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Anesthesiologist to Patient Communication: A Systematic Review.JAMA network open · 2020Pooled it
- Minimizing hospital acquired intensive care unit infections: A focus on prevention.World journal of critical care medicine · 2026Review
- Decision-Making Approaches Used to Limit Potentially Nonbeneficial Life-Prolonging Interventions.JAMA network open · 2026Article
- Neuropalliative Care in the Emergency Department: Three Roles, One Goal.Neurocritical care · 2026Review
- Breaking with the status quo in end-of-life care through de-implementation.Journal of internal medicine · 2025Review
- Palliative Care Consultation and Family-Centered Outcomes in Patients With Unplanned Intensive Care Unit Admissions.Journal of palliative medicine · 2024Article
- Giving a voice to patients at high risk of dying in the intensive care unit: a multiple source approach.Intensive care medicine · 2023Article
- More than patient benefit: taking a broader view of ICU admission decisions.Intensive care medicine · 2023Article
- Differences in Characteristics, Hospital Care, and Outcomes between Acute Critically Ill Emergency Department Patients Receiving Palliative Care and Usual Care.International journal of environmental research and public health · 2021Observational
- Article
- Clinicians' Perspectives After Implementation of the Serious Illness Care Program: A Qualitative Study.JAMA network open · 2021Article
- Physicians' Views and Agreement about Patient- and Context-Related Factors Influencing ICU Admission Decisions: A Prospective Study.Journal of clinical medicine · 2021Article
- Evaluation of Time-Limited Trials Among Critically Ill Patients With Advanced Medical Illnesses and Reduction of Nonbeneficial ICU Treatments.JAMA internal medicine · 2021Article
- Delivery of end-of-life care in an emergency department-based intensive care unit.Journal of the American College of Emergency Physicians open · 2020Article
- Bereavement Support on the Frontline of COVID-19: Recommendations for Hospital Clinicians.Journal of pain and symptom management · 2020Article
- Illness as Transformative Experience: Implications of Philosophy for Advance Care Planning.Journal of pain and symptom management · 2020Article
- Enhanced perioperative communication elevates patients' understanding, perception, and satisfaction for anesthesia services: Insights from a survey study.Saudi journal of anaesthesiaArticle
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Authors and funding
6 authors.
Funding
Abstract
For patients with chronic, life-limiting illnesses, admission to the intensive care unit (ICU) near the end of life might not improve patient outcomes or be consistent with patient and family values, goals, and preferences. In this context, advance care planning and palliative care interventions designed to clarify patients' values, goals, and preferences have the potential to reduce provision of high-intensity interventions that are unwanted or non-beneficial. In this Series paper, we have assessed interventions that are effective at helping patients with chronic, life-limiting illnesses to avoid an unwanted ICU admission. The evidence found was largely from observational studies, with considerable heterogeneity in populations, methods, and types of interventions. Results from randomised trials of interventions to improve communication about goals of care are scarce, of variable quality, and mixed. Although observational studies show that advance care planning and palliative care interventions are associated with a reduced number of ICU admissions at the end of life, causality has not been well established. Using the available evidence we suggest recommendations to help to avoid ICU admission when it does not align with patient and family values, goals, and preferences and conclude with future directions for research.
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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.