Evidence map›Paper›PMID 36400406›Full record

ArticleJournal of pain and symptom management2023

Determining Goal Concordant Care in the Intensive Care Unit Using Electronic Health Records.

Sumera R Ahmad, Alex D Tarabochia, LuAnn Budahn, Allison M LeMahieu, Lioudmila V Karnatovskaia, Alison E Turnbull, Ognjen Gajic

Abstract read
In one paragraph

Article in Journal of pain and symptom management, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
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

5 citing papers in PubMed.

  1. Observational
  2. Review
  3. Article
  4. Goals of Care Assessment during Hospitalization for Sepsis.Annals of the American Thoracic Society · 2025
    Article
  5. Article
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

7 authors.

Sumera R AhmadDivision of Pulmonary and Critical Care Medicine (S.R.A., L.k., O.G.), Mayo Clinic, Rochester, Minnesota. Electronic address: ahmad.sumera@mayo.edu.
Alex D TarabochiaDepartment of Internal Medicine (A.D.T.), Mayo Clinic, Rochester, Minnesota.
LuAnn BudahnAnesthesia and Critical Care Research Unit (L.B.), Mayo Clinic, Rochester, Minnesota.
Allison M LeMahieuDepartment of Quantitative Health Sciences (A.M.L.), Mayo Clinic, Rochester, Minnesota.
Lioudmila V KarnatovskaiaDivision of Pulmonary and Critical Care Medicine (S.R.A., L.k., O.G.), Mayo Clinic, Rochester, Minnesota.
Alison E TurnbullDivision of Pulmonary and Critical Care Medicine, School of Medicine (A.E.T.), Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology, Bloomberg School of Public Health (A.E.T.), Johns Hopkins University, Baltimore, Maryland; Outcomes After Critical Illness and Surgery Research group (A.E.T.), Johns Hopkins University, Baltimore, Maryland.
Ognjen GajicDivision of Pulmonary and Critical Care Medicine (S.R.A., L.k., O.G.), Mayo Clinic, Rochester, Minnesota.

Funding

Psychological support based on positive suggestions in acute respiratory failure patientsK23HL146741 · NHLBI · MAYO CLINIC ROCHESTER · PI KARNATOVSKAIA, LIOUDMILA · 2020 to 2024
$929k
NHLBI NIH HHS K23 HL146741
6 · The paper itself

Abstract

backgroundGoal concordant care (GCC) is the alignment of care to patient values and preferences. GCC is a major outcome of communication with patients and families in serious/critical illness. Using the electronic health record (EHR) to study the provision of GCC would be pragmatic and cost-effective for research and quality improvement efforts. RESEARCH QUESTION: Do EHRs contain information to identify GCC?

methodsThis is a feasibility retrospective chart review performed by two independent reviewers. An existing framework containing four questions for identifying GCC was adopted. Two clinicians reviewed multi-disciplinary notes and extracted pertinent information. The primary outcomes were whether the four key questions for determining goal concordance could be answered using information in the EHR. The secondary outcome was the type of goals identified. Cohen's kappa was used to measure agreement between two reviewers.

resultsPatient care was considered goal concordant in 35 (85%) of 41 patients in a random sample comprising of 36 survivors and five who died in hospital. Inter-rater agreement on identifying data to determine GCC was excellent (Kappa 0.70). Patient goals were identified in 80% of charts reviewed. Note sources informative of patient preferences, included social work (39%), hospital progress notes (29%), palliative care (20%), and physical/occupational therapy (15%). "Returning home" and "getting better/ stronger" were among the most common patient goals captured in EHR.

conclusionThe EHR can be used to understand patient goals, but the information is scattered across the multi-disciplinary notes. Improving EHR and external validation will facilitate ascertainment of goal concordance as an important outcome measure.

Indexed as

Electronic Health RecordsGoalsHumansIntensive Care UnitsPalliative CareRetrospective Studiescritical illnesselectronic health record (EHR)Goal concordant carepatient goals

Identifiers

PMID36400406
PMCPMC10557174

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.