Evidence map›Paper›PMID 38193805›Full record

ArticleJournal of the American Geriatrics Society2024

Surrogate decision-makers from historically marginalized populations have lower levels of preparedness for care planning.

Lingsheng Li, Deborah E Barnes, Sarah Nouri, Ying Shi, Aiesha M Volow, Mariko Feuz, Brookelle H Li, Rebecca L Sudore

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

Article in Journal of the American Geriatrics Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
4.9field-weighted citation impact, top 5% 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

6 citing papers in PubMed, 9 citations in OpenAlex.

  1. Trial
  2. Article
  3. Article
  4. Article
  5. Development of web- and mobile-based shared decision-making tools in the neurological intensive care unit.Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics · 2025
    Review
  6. 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

8 authors at 2 institutions in 1 country.

Lingsheng LiDivision of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA.ORCID 0000-0002-1278-0126
Deborah E BarnesDivision of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA.
Sarah NouriDivision of Palliative Medicine, Department of Medicine, University of California, San Francisco, California, USA.ORCID 0000-0001-7163-0366
Ying ShiDivision of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA.
Aiesha M VolowDivision of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA.
Mariko FeuzUniversity of Iowa-Des Moines Internal Medicine Residency Program, Des Moines, Iowa, USA.
Brookelle H LiDivision of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA.
Rebecca L SudoreDivision of Geriatrics, Department of Medicine, University of California, San Francisco, California, USA.
University of California, San Francisco · USUniversity of Iowa · US

Funding

VARC CoreP30AG044281 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI W. JOHN BOSCARDIN · 2013 to 2026
$19.9M
RESEARCH TRAINING IN GERIATRIC MEDICINET32AG000212 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Alexander Keliimoeanu Smith · 1991 to 2026
$7.7M
Improving advance care planning for seniors at risk for Alzheimers disease and related dementias and their caregiversR01AG045043 · NIA · NORTHERN CALIFORNIA INSTITUTE/RES/EDU · PI SUDORE, REBECCA L · 2013 to 2017
$3.2M
Mentoring Researchers in Advance Care Planning for Underrepresented Older Adults at Risk for Alzheimer’s Disease and Related Dementias and Their CaregiversK24AG054415 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI REBECCA L SUDORE · 2017 to 2026
$1.7M
Taking Advance Care Planning (ACP) to Diverse Older Adult Communities: Facilitators, Barriers, and Development of a Novel ACP ToolkitR03AG073989 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI NOURI, SARAH · 2021 to 2022
$323k
NIA NIH HHS 5K24AG054415-07NIA NIH HHS K24 AG054415NIA NIH HHS P30 AG044281NIA NIH HHS R01 AG045043NIA NIH HHS R01AG045043NIA NIH HHS R03 AG073989NIA NIH HHS R03AG073989NIA NIH HHS T32 AG000212NIA NIH HHS T32-AG000212Patient-Centered Outcomes Research Institute CDR-1306-01500
6 · The paper itself

Abstract

backgroundSurrogate preparedness for medical decision-making is an important part of care planning. This study examined preparedness and engagement among historically marginalized surrogates.

methodsSurrogates were included if they were named medical decision-makers by patients ≥55 years at a San Francisco safety-net and Veterans Affairs hospital. We assessed preparedness for medical decision-making by asking if surrogates had been formally asked to be the medical decision-maker, if patients had discussed medical wishes with surrogates, and if the surrogate role and these medical wishes had been documented. We assessed surrogate confidence and readiness using a modified Surrogate ACP Engagement Survey. We used Wilcoxon rank-sum tests to measure the association of engagement scores with surrogate characteristics.

resultsOf 422 surrogates, their mean age was 53 years (SD ±14.5), 73% were from minoritized groups, 38% were Spanish-speaking, and 15% had limited health literacy. For preparedness outcomes, 13% of surrogates were not formally asked to play this role, 46% reported the patient had not discussed end-of-life medical wishes, and 51% reported there had been no formal documentation of the surrogate role. Surrogates reported higher confidence 4.43/5 (SD ± 0.64) than readiness 3.70 (1.22) for decision-making (p < 0.001). Confidence and readiness scores were lower among historically marginalized participants.

conclusionMore resources are needed to prepare surrogate decision-makers from historically marginalized communities for discussing patient's goals of care and treatment preferences.

Indexed as

Advance Care PlanningHealth LiteracyDecision MakingHumansPatientsSan Franciscoadvance care planningcare planning continuumsurrogate decision-maker

Identifiers

PMID38193805
PMCPMC10922733
OpenAlexW4390769538

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.