Evidence map›Paper›PMID 35595375›Full record

ArticleJournal of pain and symptom management2022

Evolution of Investigating Informed Assent Discussions about CPR in Seriously Ill Patients.

Renee D Stapleton, Dee W Ford, Katherine R Sterba, Nandita R Nadig, Steven Ades, Anthony L Back, Shannon S Carson, Katharine L Cheung, Janet Ely, Erin K Kross and 19 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of pain and symptom management, 2022. 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
0.7field-weighted citation impact, top 33% 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, 5 citations in OpenAlex.

  1. Trial
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

29 authors at 10 institutions in 1 country.

Renee D StapletonPulmonary and Critical Medicine, HSRF 222 (R.D.S), University of Vermont Larner College of Medicine, Burlington, Vermont, USA. Electronic address: renee.stapleton@med.uvm.edu.
Dee W FordDivision Director and Professor, Pulmonary, Critical Care, and Sleep Medicine, CSB 816, MSC 630 (D.W.F.), Medical University of South Carolina, Charleston, South Carolina, USA.
Katherine R SterbaPublic Health Sciences (K.R.S.), Medical University of South Carolina, Charleston, South Carolina, USA.
Nandita R NadigPulmonary and Critical Care Medicine Northwestern University Feinberg School of Medicine (N.R.N.), Chicago, Illinois, USA.
Steven AdesHematology and Oncology (S.A.), University of Vermont Larner College of Medicine, Burlington, Vermont, USA.
Anthony L BackDepartment of Medicine (A.L.B.), University of Washington, Seattle, Washington, USA.
Shannon S CarsonPulmonary and Critical Care Medicine (S.S.C.), University of North Carolina, Chapel Hill, North Carolina, USA.
Katharine L CheungNephrology (K.L.C.), University of Vermont Larner College of Medicine, Burlington, Vermont, USA.
Janet ElyUniversity of Vermont Cancer Center (J.E.), Burlington, Vermont, USA.
Erin K KrossDivision of Pulmonary, Critical Care & Sleep Medicine, Co-Director of Cambia Palliative Care Center of Excellence at UW Medicine (E.K.K.), University of Washington, Seattle, Washington, USA.
Robert C MacauleyOregon Health Sciences University (R.C.M.), Portland, Oregon, USA.
Jennifer M MaguirePulmonary and Critical Care Medicine (J.M.M.), University of North Carolina, Chapel Hill, North Carolina, USA.
Theodore W MarcyPulmonary and Critical Care Medicine (T.W.M.), University of Vermont Larner College of Medicine, Burlington, Vermont, USA.
Jennifer J McEnteeInternal Medicine and Pediatrics, Palliative Care and Hospice Medicine (J.J.M.), University of North Carolina, Chapel Hill, North Carolina, USA.
Prema R MenonVertex Pharmaceuticals (P.R.M.), Boston, Massachusetts, USA.
Amanda OverstreetGeriatrics and Palliative Care (A.O.), Medical University of South Carolina, Charleston, SC.
Christine S RitchieHarvard Medical School (C.S.R.), Boston, Massachusetts, USA.
Blair WendlandtPulmonary and Critical Care Medicine (B.W.), University of North Carolina, Chapel Hill, North Carolina, USA.
Sara S ArdrenUniversity of Vermont Larner College of Medicine (S.S.A.), Burlington, Vermont, USA.
Michael BalassoneDivision of Pulmonary and Critical Care Medicine (M.B.), Medical University of South Carolina, Charleston, South Carolina, USA.
Stephanie BurnsUniversity of Vermont Larner College of Medicine (S.B.), Burlington, Vermont, USA.
Summer ChoudhuryNorth Carolina Translational and Clinical Sciences Institute (S.C.), University of North Carolina, Chapel Hill, North Carolina, USA.
Sandra DiehlUniversity of Vermont Medical Center (S.D.), Burlington, Vermont, USA.
Ellen McCownSpiritual Care (E.M.), University of Washington Medical Center, Seattle, Washington, USA.
Elizabeth L NielsenCambia Palliative Care Center of Excellence at UW Medicine (E.L.N), University of Washington, Seattle, Washington, USA.
Sudiptho R PaulPulmonary and Critical Care Medicine (S.R.P., C.R.), University of North Carolina, Chapel Hill, North Carolina, USA.
Colleen RicePulmonary and Critical Care Medicine (S.R.P., C.R.), University of North Carolina, Chapel Hill, North Carolina, USA.
Katherine K TaylorPulmonary, Critical Care, and Sleep Medicine (K.K.T), Medical University of South Carolina, Charleston, South Carolina, USA.
Ruth A EngelbergPulmonary, Critical Care & Sleep Medicine, Cambia Palliative Care Center of Excellence at UW Medicine (R.A.E.), University of Washington, Seattle, Seattle, Washington, USA.
University of Vermont · USUniversity of North Carolina at Chapel Hill · USMedical University of South Carolina · USUniversity of Washington · USHarvard University · USNorthwestern University · USOregon Health & Science University · USUniversity of Vermont Medical Center · USUniversity of Washington Medical Center · USVertex Pharmaceuticals (United States) · US

Funding

Vermont Center for Cardiovascular and Brain HealthP20GM135007 · NIGMS · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI Diego Adrianzen Herrera · 2020 to 2026
$17.4M
Improving Palliative Care for Older Seriously Hospitalized Patients and Their Families: A Randomized Trial of an Informed Assent Communication Intervention about CPRR01AG050698 · NIA · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI STAPLETON, RENEE D · 2016 to 2020
$2.6M
NIA NIH HHS R01 AG050698NIGMS NIH HHS P20 GM135007
6 · The paper itself

Abstract

contextOutcomes after cardiopulmonary resuscitation (CPR) remain poor. We have spent 10 years investigating an "informed assent" (IA) approach to discussing CPR with chronically ill patients/families. IA is a discussion framework whereby patients extremely unlikely to benefit from CPR are informed that unless they disagree, CPR will not be performed because it will not help achieve their goals, thus removing the burden of decision-making from the patient/family, while they retain an opportunity to disagree.

objectivesDetermine the acceptability and efficacy of IA discussions about CPR with older chronically ill patients/families.

methodsThis multi-site research occurred in three stages. Stage I determined acceptability of the intervention through focus groups of patients with advanced COPD or malignancy, family members, and physicians. Stage II was an ambulatory pilot randomized controlled trial (RCT) of the IA discussion. Stage III is an ongoing phase 2 RCT of IA versus attention control in in patients with advanced chronic illness.

resultsOur qualitative work found the IA approach was acceptable to most patients, families, and physicians. The pilot RCT demonstrated feasibility and showed an increase in participants in the intervention group changing from "full code" to "do not resuscitate" within two weeks after the intervention. However, Stages I and II found that IA is best suited to inpatients. Our phase 2 RCT in older hospitalized seriously ill patients is ongoing; results are pending.

conclusionsIA is a feasible and reasonable approach to CPR discussions in selected patient populations.

Indexed as

Cardiopulmonary ResuscitationDecision MakingAgedCritical IllnessHospitalizationHumansInpatientsResuscitation Orderscardiopulmonary resuscitationCode statuscommunicationend-of-lifeseriously ill patients

Identifiers

PMID35595375
PMCPMC9179950
OpenAlexW4280549464

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.