Evidence map›Paper›PMID 35700932›Full record

Trial reportJournal of pain and symptom management2022

Seriously Ill Patients' Prioritized Goals and Their Clinicians' Perceptions of Those Goals.

Matthew E Modes, Ruth A Engelberg, Elizabeth L Nielsen, Lyndia C Brumback, Thanh H Neville, Anne M Walling, J Randall Curtis, Erin K Kross

Open access · greenAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report 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 10 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed, 1 pooled it
3.2field-weighted citation impact, top 8% 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

10 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Leveraging the electronic health record to identify delivery of goal-concordant care.medRxiv : the preprint server for health sciences · 2024
    Article
  6. Article
  7. Article
  8. Article
  9. Article
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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

8 authors at 3 institutions in 1 country.

Matthew E ModesDivision of Pulmonary and Critical Care Medicine (M.E.M), Cedars-Sinai Medical Center, Los Angeles, California, USA. Electronic address: matthew.modes@cshs.org.
Ruth A EngelbergDivision of Pulmonary (R.A.E., E.L.N., J.R.C., E.K.K.), Critical Care and Sleep Medicine, University of Washington, Seattle, Washington, USA; Cambia Palliative Care Center of Excellence (R.A.E., E.L.N., L.C.B., J.R.C., E.K.K.), University of Washington, Seattle, Washington, USA.
Elizabeth L NielsenDivision of Pulmonary (R.A.E., E.L.N., J.R.C., E.K.K.), Critical Care and Sleep Medicine, University of Washington, Seattle, Washington, USA; Cambia Palliative Care Center of Excellence (R.A.E., E.L.N., L.C.B., J.R.C., E.K.K.), University of Washington, Seattle, Washington, USA.
Lyndia C BrumbackCambia Palliative Care Center of Excellence (R.A.E., E.L.N., L.C.B., J.R.C., E.K.K.), University of Washington, Seattle, Washington, USA; Department of Biostatistics (L.C.B.), University of Washington, Seattle, Washington, USA.
Thanh H NevilleDivision of Pulmonary (T.H.N.), Critical Care, and Sleep Medicine, University of California Los Angeles, Los Angeles, California, USA.
Anne M WallingDivision of General Internal Medicine and Health Services Research (A.M.W.), University of California Los Angeles, Los Angeles, California, USA; Center for the Study of Healthcare Innovation (A.M.W.), Implementation and Policy, Veterans Affairs Greater Los Angeles Health Care System, Los Angeles, California, USA.
J Randall CurtisDivision of Pulmonary (R.A.E., E.L.N., J.R.C., E.K.K.), Critical Care and Sleep Medicine, University of Washington, Seattle, Washington, USA; Cambia Palliative Care Center of Excellence (R.A.E., E.L.N., L.C.B., J.R.C., E.K.K.), University of Washington, Seattle, Washington, USA; Department of Bioethics and Humanities (J.R.C.), University of Washington, Seattle, Washington, USA.
Erin K KrossDivision of Pulmonary (R.A.E., E.L.N., J.R.C., E.K.K.), Critical Care and Sleep Medicine, University of Washington, Seattle, Washington, USA; Cambia Palliative Care Center of Excellence (R.A.E., E.L.N., L.C.B., J.R.C., E.K.K.), University of Washington, Seattle, Washington, USA.
University of Washington · USUniversity of California, Los Angeles · USCedars-Sinai Medical Center · US

Funding

RESPIRATORY RESEARCH TRAINING PROGRAMT32HL007287 · NHLBI · UNIVERSITY OF WASHINGTON · PI Kristina Anne Crothers, David J. Horne · 1985 to 2026
$16.7M
Palliative Care Research Training GrantT32HL125195 · NHLBI · UNIVERSITY OF WASHINGTON · PI KROSS, ERIN KATHRYN, SHARMA, RASHMI K. · 2015 to 2024
$3.2M
NHLBI NIH HHS T32 HL007287NHLBI NIH HHS T32 HL125195
6 · The paper itself

Abstract

contextSeriously ill patients whose prioritized healthcare goals are understood by their clinicians are likely better positioned to receive goal-concordant care.

objectivesTo examine the proportion of seriously ill patients whose prioritized healthcare goal is accurately perceived by their clinician and identify factors associated with accurate perception.

methodsSecondary analysis of a multicenter cluster-randomized trial of outpatients with serious illness and their clinicians. Approximately two weeks after a clinic visit, patients reported their current prioritized healthcare goal- extending life over relief of pain and discomfort, or relief of pain and discomfort over extending life - and clinicians reported their perception of their patients' current prioritized healthcare goal; matching these items defined accurate perception.

resultsOf 252 patients with a prioritized healthcare goal, 60% had their goal accurately perceived by their clinician, 27% were cared for by clinicians who perceived prioritization of the alternative goal, and 13% had their clinician answer unsure. Patients who were older (OR 1.03 per year; 95%CI 1.01, 1.05), had stable goals (OR 2.52; 95%CI 1.26, 5.05), and had a recent goals-of-care discussion (OR 1.78, 95%CI 1.00, 3.16) were more likely to have their goals accurately perceived.

conclusionA majority of seriously ill outpatients are cared for by clinicians who accurately perceive their patients' prioritized healthcare goals. However, a substantial portion are not and may be at higher risk for goal-discordant care. Interventions that facilitate goals-of-care discussions may help align care with goals, as recent discussions were associated with accurate perceptions of patients' prioritized goals.

Indexed as

Advance Care PlanningGoalsCommunicationHumansPainAdvance care planning (ACP)Clinician identificationClinician perceptionClinician understandingEnd-of-lifeGoal-concordant careGoalsGoals-of-carePalliative carePreferencesSerious illnessValues

Identifiers

PMID35700932
PMCPMC9482939
OpenAlexW4282973736

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.