ArticleContemporary clinical trials2022
Improving communication about goals of care for hospitalized patients with serious illness: Study protocol for two complementary randomized trials.
Article in Contemporary clinical trials, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT04281784 (Using the Electronic Health Record to Identify and Promote Goals-of-Care Communication for Older Patients With Serious Illness), which is not on this map. Cited by 8 papers.
What it found
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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.
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.
Using the Electronic Health Record to Identify and Promote Goals-of-Care Communication for Older Patients With Serious Illness
Who cites it
8 citing papers in PubMed, 12 citations in OpenAlex.
- Assessment of Natural Language Processing of Electronic Health Records to Measure Goals-of-Care Discussions as a Clinical Trial Outcome.JAMA network open · 2023Trial
- A modular pipeline for natural language processing-screened human abstraction of a pragmatic trial outcome from electronic health records.Clinical trials (London, England) · 2026Article
- Integrating rapid response systems and patient centered goals of care discussions.Frontiers in medicine · 2026Article
- Assessment of a Zero-Shot Large Language Model in Measuring Documented Goals-of-Care Discussions.Journal of pain and symptom management · 2026Article
- A modular pipeline for natural language processing-screened human abstraction of a pragmatic trial outcome from electronic health records.medRxiv : the preprint server for health sciences · 2025Article
- Performance of Predefined Search Patterns for Identifying Documented Goals-of-Care Discussions in Inpatient Electronic Health Records.Journal of palliative medicine · 2025Article
- Article
- US clinicians' perspectives on advance care planning for persons with dementia: A qualitative study.Journal of the American Geriatrics Society · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
14 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAlthough goals-of-care discussions are important for high-quality palliative care, this communication is often lacking for hospitalized older patients with serious illness. Electronic health records (EHR) provide an opportunity to identify patients who might benefit from these discussions and promote their occurrence, yet prior interventions using the EHR for this purpose are limited. We designed two complementary yet independent randomized trials to examine effectiveness of a communication-priming intervention (Jumpstart) for hospitalized older adults with serious illness.
methodsWe report the protocol for these 2 randomized trials. Trial 1 has two arms, usual care and a clinician-facing Jumpstart, and is a pragmatic trial assessing outcomes with the EHR only (n = 2000). Trial 2 has three arms: usual care, clinician-facing Jumpstart, and clinician- and patient-facing (bi-directional) Jumpstart (n = 600). We hypothesize the clinician-facing Jumpstart will improve outcomes over usual care and the bi-directional Jumpstart will improve outcomes over the clinician-facing Jumpstart and usual care. We use a hybrid effectiveness-implementation design to examine implementation barriers and facilitators. OUTCOMES: For both trials, the primary outcome is EHR documentation of a goals-of-care discussion within 30 days of randomization; additional outcomes include intensity of end-of-life care. Trial 2 also examines patient- or family-reported outcomes assessed by surveys targeting 3-5 days and 4-8 weeks after randomization including quality of goals-of-care communication, receipt of goal-concordant care, and psychological symptoms.
conclusionsThis novel study incorporates two complementary randomized trials and a hybrid effectiveness-implementation approach to improve the quality and value of care for hospitalized older adults with serious illness. CLINICAL TRIALS REGISTRATION: STUDY00007031-A and STUDY00007031-B.
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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.