Evidence map›Paper›PMID 37643654›Full record

ReviewJournal of pain and symptom management2023

Impact of an Institution-Wide Goals of Care Program on the Timing of Referrals to Outpatient Palliative Care.

Akhila Reddy, Joannis Baez González, Ali Rizvi, Nico Nortje, Shalini Dalal, Ali Haider, Jaya Sheela Amaram-Davila, Patricia Bramati, Minxing Chen, David Hui and 1 more

Abstract readReview
PubMed Full text at PMC Publisher
In one paragraph

Review 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. Early integration or last consultation: in-house palliative care involvement for hospitalized patients in tertiary medicine-a retrospective analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
    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

11 authors.

Akhila ReddyDepartments of Palliative, Rehabilitation, and Integrative Medicine, Critical Care Medicine, (A.R., J.B.G., A.R., S.D., A.H., J.S.A.D., P.B., D.H., E.B.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA. Electronic address: asreddy@mdanderson.org.
Joannis Baez GonzálezDepartments of Palliative, Rehabilitation, and Integrative Medicine, Critical Care Medicine, (A.R., J.B.G., A.R., S.D., A.H., J.S.A.D., P.B., D.H., E.B.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Ali RizviDepartments of Palliative, Rehabilitation, and Integrative Medicine, Critical Care Medicine, (A.R., J.B.G., A.R., S.D., A.H., J.S.A.D., P.B., D.H., E.B.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Nico NortjeSection of Integrated Ethics (N.N.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Shalini DalalDepartments of Palliative, Rehabilitation, and Integrative Medicine, Critical Care Medicine, (A.R., J.B.G., A.R., S.D., A.H., J.S.A.D., P.B., D.H., E.B.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Ali HaiderDepartments of Palliative, Rehabilitation, and Integrative Medicine, Critical Care Medicine, (A.R., J.B.G., A.R., S.D., A.H., J.S.A.D., P.B., D.H., E.B.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Jaya Sheela Amaram-DavilaDepartments of Palliative, Rehabilitation, and Integrative Medicine, Critical Care Medicine, (A.R., J.B.G., A.R., S.D., A.H., J.S.A.D., P.B., D.H., E.B.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Patricia BramatiDepartments of Palliative, Rehabilitation, and Integrative Medicine, Critical Care Medicine, (A.R., J.B.G., A.R., S.D., A.H., J.S.A.D., P.B., D.H., E.B.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Minxing ChenDepartment of Biostatistics (M.C.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
David HuiDepartments of Palliative, Rehabilitation, and Integrative Medicine, Critical Care Medicine, (A.R., J.B.G., A.R., S.D., A.H., J.S.A.D., P.B., D.H., E.B.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Eduardo BrueraDepartments of Palliative, Rehabilitation, and Integrative Medicine, Critical Care Medicine, (A.R., J.B.G., A.R., S.D., A.H., J.S.A.D., P.B., D.H., E.B.), The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.

Funding

Tumor Evolution and Metastasis ProgramP30CA016672 · NCI · UNIVERSITY OF TX MD ANDERSON CAN CTR · PI Scott Kopetz · 1985 to 2026
$290.8M
NCI NIH HHS P30 CA016672
6 · The paper itself

Abstract

contextPalliative care has received increased interest since the COVID-19 pandemic due to its role in guiding goals of care (GOC) discussions.

objectivesWe assessed the change in the timing of outpatient palliative care referrals before and after implementing an institution-wide multicomponent interdisciplinary GOC (myGOC) program.

methodsWe reviewed 200 random supportive care center (SCC) consult visits each from June to November 2019 (before myGOC) and June to November 2020 (after myGOC). Data regarding Edmonton Symptom Assessment Scale (ESAS) scores, time from hospital registration to SCC visit, SCC visit until death/last follow-up, and advance care planning (ACP) notes were collected. Kaplan-Meier curves were used to evaluate overall survival (OS).

resultsThe median OS from the SCC consult visit was 15.2 months (95% CI:11.7-19.7) before and 14.0 months (95% CI:10.8-17.9) after the myGOC program (P = 0.646). There were no significant differences in the median time between the SCC consult visit to death/last follow-up (11.95 vs. 12.0 months after myGOC; P = 0.841) and the first visits to our cancer center and SCC (6.1 vs. 5.29 months after myGOC; P = 0.689). Patients seen after myGOC had significantly lower ESAS symptom scores, better performance status (2 [1-2] vs. 2 [1-3]; P = 0.018], and more ACP notes composed by medical oncology teams (25.5% vs. 4.5%; P < 0.001).

conclusionThere were no significant differences in OS among patients seen in the SCC before and after myGOC, likely related to a ceiling effect. More oncologists had ACP discussions with patients, and patients had lower symptom scores on ESAS after myGOC, likely indicating that more patients were referred for GOC discussions and ACP rather than for symptom distress.

Indexed as

NeoplasmsPalliative CareHumansOutpatientsPandemicsPatient Care PlanningReferral and Consultationadvance care planningcancerCOVID-19goals of carePalliative caresupportive care

Identifiers

PMID37643654
PMCPMC11815992

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Registered trials

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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.