Evidence map›Paper›PMID 31197540›Full record

ArticleSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2020

A mixed methods analysis of patients' advance care planning values in outpatient oncology: Person-Centered Oncologic Care and Choices (P-COCC).

Rajiv Agarwal, Elyse Shuk, Danielle Romano, Margaux Genoff, Yuelin Li, Eileen M O'Reilly, William Breitbart, Angelo E Volandes, Andrew S Epstein

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Article in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–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.

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

6 citing papers in PubMed.

  1. Trial
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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.

Rajiv AgarwalMemorial Sloan Kettering Cancer Center, 300 E. 66th Street, Room 1013, New York, NY, 10065, USA.
Elyse ShukMemorial Sloan Kettering Cancer Center, 300 E. 66th Street, Room 1013, New York, NY, 10065, USA.
Danielle RomanoMemorial Sloan Kettering Cancer Center, 300 E. 66th Street, Room 1013, New York, NY, 10065, USA.
Margaux GenoffMemorial Sloan Kettering Cancer Center, 300 E. 66th Street, Room 1013, New York, NY, 10065, USA.
Yuelin LiMemorial Sloan Kettering Cancer Center, 300 E. 66th Street, Room 1013, New York, NY, 10065, USA.
Eileen M O'ReillyMemorial Sloan Kettering Cancer Center, 300 E. 66th Street, Room 1013, New York, NY, 10065, USA.
William BreitbartMemorial Sloan Kettering Cancer Center, 300 E. 66th Street, Room 1013, New York, NY, 10065, USA.
Angelo E VolandesMassachusetts General Hospital, Boston, MA, USA.
Andrew S EpsteinMemorial Sloan Kettering Cancer Center, 300 E. 66th Street, Room 1013, New York, NY, 10065, USA. epsteina@mskcc.org.ORCID http://orcid.org/0000-0003-1808-3070

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Hongbiao Carl Lekaye · 1985 to 2026
$347.4M
Vanderbilt Clinical Oncology Research Career Development ProgramK12CA090625 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI Debra L. Friedman, Paula Jill Hurley · 2001 to 2026
$16.9M
National Palliative Care Research Center 2013 Career Development AwardNCI NIH HHS K12 CA090625NCI NIH HHS P30 CA008748
6 · The paper itself

Abstract

purposePerson-Centered Oncologic Care and Choices (P-COCC) combines an advance care planning (ACP) value-focused patient interview with a care goal video decision aid. Our randomized study showed that P-COCC was acceptable but increased participant distress, compared with video-alone and usual care study arms. This mixed methods approach explores the ACP values in the P-COCC arm and their relationship to the distress phenomenon.

methodsQualitative thematic analysis of the 46 audio-recorded P-COCC interview transcripts with advanced gastrointestinal cancer patients was performed by multiple reviewers. Quantitative (Likert scale) changes in ACP values were compared across study arms. ACP themes and value change were analyzed in participants with increased distress.

resultsTranscript analysis resulted in thematic saturation and identified eight distinct themes on ACP values relating to end-of-life wishes, communication needs, and psychosocial supports. Of 98 participants (33 P-COCC, 43 videos, 22 usual care) who completed the change in value measure, there was no difference detected with P-COCC compared with either video (p = 0.052) or usual care (p = 0.105) arms alone, but P-COCC led to a frequency distribution of more change in personal values compared with the other study arms combined (p = 0.043). Among the subset of P-COCC participants with increased distress, there was no statistical relationship with change in values.

conclusionsThe ACP paradigm P-COCC both informs and supports patients in individualized, value-based decision-making. Distress is not associated with changes in ACP values and may be a necessary, at least transient, byproduct of discussing sensitive but pertinent topics about end-of-life medical care.

Indexed as

Advance Care PlanningDecision MakingPsychological DistressAgedCommunicationDecision Support TechniquesFemaleGastrointestinal NeoplasmsHumansMaleMedical OncologyMiddle AgedOutpatientsPatient Care PlanningSelf CareTerminal CareAdvance care planningCancerCommunicationGoalsPatient participation

Identifiers

PMID31197540
PMCPMC6908761

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Registered trials

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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.