Trial reportJournal of cardiac failure2021
Non-Concordance between Patient and Clinician Estimates of Prognosis in Advanced Heart Failure.
Trial report in Journal of cardiac failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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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.
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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.
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Who cites it
9 citing papers in PubMed, 18 citations in OpenAlex.
- Understanding of Prognosis and Estimation of Mortality in Ambulatory Patients With Heart Failure.JAMA network open · 2026Article
- Identifying and overcoming barriers to referral in advanced heart failure. A scientific statement of the Heart Failure Association (HFA) of the ESC.European journal of heart failure · 2025Review
- Article
- Using the 5Ms Framework to Advance Aging-Responsive Care for Heart Failure with Reduced Ejection Fraction.Clinical interventions in aging · 2025Review
- Gaps in Heart Failure Care: The Need for Effective Communication and Health Literacy-concordant Patient Education.US cardiology · 2025Review
- Prognosis Communication in Heart Failure: Experiences and Preferences of End-Stage Heart Failure Patients and Care Partners.Circulation. Cardiovascular quality and outcomes · 2024Article
- Using Latent Class Analysis to Identify Different Clinical Profiles Among Patients With Advanced Heart Failure.Journal of pain and symptom management · 2023Article
- Readiness of Advance Care Planning Among Patients With Cardiovascular Disease.Frontiers in cardiovascular medicine · 2022Article
- Enhancing Palliative Care for Patients With Advanced Heart Failure Through Simple Prognostication Tools: A Comparison of the Surprise Question, the Number of Previous Heart Failure Hospitalizations, and the Seattle Heart Failure Model for Predicting 1-Year Survival.Frontiers in cardiovascular medicine · 2022Article
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Authors and funding
12 authors at 7 institutions in 1 country.
Funding
Abstract
importanceDespite efforts to enhance serious illness communication, patients with advanced heart failure (HF) lack prognostic understanding.
objectivesTo determine rate of concordance between HF patients' estimation of their prognosis and their physician's estimate of the patient's prognosis, and to compare patient characteristics associated with concordance.
designCross-sectional analysis of a cluster randomized controlled trial with 24-month follow-up and analysis completed on 09/01/2020. Patients were enrolled in inpatient and outpatient settings between September 2011 to February 2016 and data collection continued until the last quarter of 2017.
settingSix teaching hospitals in the U.S.
participantsPatients with advanced HF and implantable cardioverter defibrillators (ICDs) at high risk of death. Of 537 patients in the parent study, 407 had complete data for this analysis.
interventionA multi-component communication intervention on conversations between HF clinicians and their patients regarding ICD deactivation and advance care planning. MAIN OUTCOME(S) AND MEASURE(S): Patient self-report of prognosis and physician response to the "surprise question" of 12-month prognosis. Patient-physician prognostic concordance (PPPC) measured in percentage agreement and kappa. Bivariate analyses of characteristics of patients with and without PPPC.
resultsAmong 407 patients (mean age 62.1 years, 29.5% female, 42.4% non-white), 300 (73.7%) dyads had non-PPPC; of which 252 (84.0%) reported a prognosis >1 year when their physician estimated <1 year. Only 107 (26.3%) had PPPC with prognosis of ≤ 1 year (n=20 patients) or > 1 year (n=87 patients); (Κ = -0.20, p = 1.0). Of those with physician estimated prognosis of < 1 year, non-PPPC was more likely among patients with lower symptom burden- number and severity (both p ≤.001), without completed advance directive (p=.001). Among those with physician prognosis estimate > 1 year, no patient characteristic was associated with PPPC or non-PPPC. CONCLUSIONS AND RELEVANCE: Non-PPPC between HF patients and their physicians is high. HF patients are more optimistic than clinicians in estimating life expectancy. These data demonstrate there are opportunities to improve the quality of prognosis disclosure between patients with advanced HF and their physicians. Interventions to improve PPPC might include serious illness communication training.
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