Trial reportAge and ageing2022
BABEL (Better tArgeting, Better outcomes for frail ELderly patients) advance care planning: a comprehensive approach to advance care planning in nursing homes: a cluster randomised trial.
Trial report in Age and ageing, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 5 of them syntheses 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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
9 citing papers in PubMed, 5 syntheses or guidelines pooled it, 19 citations in OpenAlex.
- Experiences and perspectives of older adults in nursing homes and their families participating in advance care planning: a meta-synthesis of qualitative studies.BMC palliative care · 2025Pooled it
- Family perspectives on and experiences with advance care planning in nursing homes: A thematic synthesis.Journal of advanced nursing · 2025Pooled it
- Models for delivery and co-ordination of primary or secondary health care (or both) to older adults living in aged care facilities.The Cochrane database of systematic reviews · 2024Pooled it
- Advance care planning for frail elderly: are we missing a golden opportunity? A mixed-method systematic review and meta-analysis.BMJ open · 2023Pooled it
- Pooled it
- A Scoping Review of Interventions Using an interRAI Information System to Guide Care Management and Assess Intervention Efficacy in Older Adults.Healthcare management forum · 2026Article
- EMTReK Model for Advance Care Planning in Long-Term Care: Qualitative Findings from mySupport Study.Geriatrics (Basel, Switzerland) · 2025Article
- Article
- Tools for tomorrow: a scoping review of patient-facing tools for advance care planning.Palliative care and social practice · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
15 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundNursing home (NH) residents should have the opportunity to consider, discuss and document their healthcare wishes. However, such advance care planning (ACP) is frequently suboptimal.
objectiveAssess a comprehensive, person-centred ACP approach.
designUnblinded, cluster randomised trial.
settingFourteen control and 15 intervention NHs in three Canadian provinces, 2018-2020. SUBJECTS: 713 residents (442 control, 271 intervention) aged ≥65 years, with elevated mortality risk.
methodsThe intervention was a structured, $\sim$60-min discussion between a resident, substitute decision-maker (SDM) and nursing home staff to: (i) confirm SDMs' identities and role; (ii) prepare SDMs for medical emergencies; (iii) explain residents' clinical condition and prognosis; (iv) ascertain residents' preferred philosophy to guide decision-making and (v) identify residents' preferred options for specific medical emergencies. Control NHs continued their usual ACP processes. Co-primary outcomes were: (a) comprehensiveness of advance care planning, assessed using the Audit of Advance Care Planning, and (b) Comfort Assessment in Dying. Ten secondary outcomes were assessed. P-values were adjusted for all 12 outcomes using the false discovery rate method.
resultsThe intervention resulted in 5.21-fold higher odds of respondents rating ACP comprehensiveness as being better (95% confidence interval [CI] 3.53, 7.61). Comfort in dying did not differ (difference = -0.61; 95% CI -2.2, 1.0). Among the secondary outcomes, antimicrobial use was significantly lower in intervention homes (rate ratio = 0.79, 95% CI 0.66, 0.94).
conclusionsSuperior comprehensiveness of the BABEL approach to ACP underscores the importance of allowing adequate time to address all important aspects of ACP and may reduce unwanted interventions towards the end of life.
Indexed as
Identifiers
What OpenQuestion holds
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.