Evidence map›Paper›PMID 31287929›Full record

Observational studyJournal of the American Geriatrics Society2019

Serious Illness and End-of-Life Treatments for Nurses Compared with the General Population.

Julie Bynum, Honor Passow, Andrea Austin, Donald Carmichael, Francine Grodstein

Open access · bronzeAbstract readObservational Study
In one paragraph

Observational study in Journal of the American Geriatrics Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 38% 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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Culture and Sanity at the End of Life.Journal of the American Geriatrics Society · 2019
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Julie BynumDepartment of Internal Medicine, Division of Geriatric and Palliative Medicine, University of Michigan, Ann Arbor, Michigan.
Honor PassowDartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Andrea AustinDartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Donald CarmichaelDartmouth Institute for Health Policy and Clinical Practice at the Geisel School of Medicine at Dartmouth, Hanover, New Hampshire.
Francine GrodsteinChanning Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.
Dartmouth Institute for Health Policy and Clinical Practice · USHarvard University · USMichigan Medicine · US

Funding

UNDERSTANDING AND IMPROVING EPISODE-BASED HOSPITAL CAREP01AG019783 · NIA · DARTMOUTH COLLEGE · PI Leila S. Agha · 2001 to 2026
$52.9M
Relationship of Cognitive Decline with Healthcare Costs and Hospitalization RiskR21AG045618 · NIA · DARTMOUTH COLLEGE · PI BYNUM, JULIE PW · 2014 to 2015
$465k
NIA NIH HHS P01 AG019783NIA NIH HHS R21 AG045618
6 · The paper itself

Abstract

objectivesAs key team members caring for people with advanced illness, nurses teach patients and families about managing their illnesses and help them to understand their options. Our objective was to determine if nurses' personal healthcare experience with serious illness and end-of-life (EOL) care differs from the general population as was shown for physicians.

designObservational propensity-matched cohort study.

settingFee-for-service Medicare.

participantsNurses' Health Study (NHS) and a random 20% national sample of Medicare beneficiaries aged 66 years or older with Alzheimer's disease and related dementias (ADRD) or congestive heart failure (CHF) diagnosed in the hospital. MEASUREMENTS: Characteristics of care during the first year after diagnosis and the last 6 months of life (EOL).

resultsAmong 57 660 NHS participants, 7380 had ADRD and 5375 had CHF; 3227 ADRD patients and 2899 CHF patients subsequently died. Care patterns in the first year were similar for NHS participants and the matched national sample: hospitalization rates, emergency visits, and preventable hospitalizations were no different in either disease. Ambulatory visits were slightly higher for NHS participants than the national sample with ADRD (13.1 vs 12.5 visits; P < .01) and with CHF (13.7 vs 12.5; P < .001). Decedents in the NHS and national sample had similar acute care use (hospitalization and emergency visits) in both diseases, but those with ADRD were less likely to use life-prolonging treatments such as mechanical ventilation (10.9% vs 13.5%; P = .001), less likely to die in a hospital with a stay in the intensive care unit (10.4% vs 12.1%; P = .03), and more likely to use hospice (58.9% vs 54.8%; P < .001). CHF at the EOL results were similar.

conclusionsNurses with newly identified serious illness experience similar care as the general Medicare population. However, at EOL, nurses are more likely to choose less aggressive treatments than the patients for whom they care. J Am Geriatr Soc 67:1582-1589, 2019.

Indexed as

Alzheimer DiseaseHeart FailureNursesPatient Acceptance of Health CareTerminal CareAgedAged, 80 and overFee-for-Service PlansFemaleHospitalizationHumansMedicarePropensity ScoreUnited StatesAlzheimer's diseasecongestive heart failureend of lifeMedicarenurses

Identifiers

PMID31287929
PMCPMC8559590
OpenAlexW2956469901

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.