Evidence map›Paper›PMID 40106743›Full record

Trial reportJCO oncology practice2025

Facilitated Versus Patient-Directed Advance Care Planning Among Patients With Advanced Cancer: A Randomized Clinical Trial.

Yael Schenker, Shane C Belin, Tianxiu Wang, Rebecca L Sudore, Bernard Hammes, Robert M Arnold, Roberta Flowers, Eric Chiu, Julian Hall, Yvette Dudley-Morrissey and 9 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in JCO oncology practice, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Trial
  4. 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

19 authors.

Yael SchenkerDivision of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA.ORCID 0000-0003-1307-9988
Shane C BelinDivision of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA.
Tianxiu WangDivision of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA.
Rebecca L SudoreDivision of Geriatrics, Department of Medicine, University of California, San Francisco, San Francisco, CA.ORCID 0000-0003-4436-2209
Bernard HammesRespecting Choices, La Crosse, WI.
Robert M ArnoldIcahn School of Medicine at Mount Sinai, New York, NY.
Roberta FlowersPalliative Research Center (PaRC), University of Pittsburgh, Pittsburgh, PA.
Eric ChiuDivision of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA.ORCID 0000-0002-7828-4061
Julian HallDivision of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA.
Yvette Dudley-MorrisseyDivision of General Internal Medicine, University of Pittsburgh, Pittsburgh, PA.
Betty FerrellCity of Hope Medical Center, Los Angeles, CA.ORCID 0000-0003-0061-5235
Megan Crowley-MatokaFeinberg School of Medicine, Northwestern University, Chicago, IL.
Adam BrufskyUPMC Hillman Cancer Center, Pittsburgh, PA.ORCID 0000-0001-8080-7960
Edward ChuMontefiore Einstein Comprehensive Cancer Center, Bronx, NY.
Vikram GorantlaUPMC Hillman Cancer Center, Pittsburgh, PA.
Dhaval MehtaUPMC Hillman Cancer Center, Pittsburgh, PA.
Roby ThomasUPMC Hillman Cancer Center, Pittsburgh, PA.ORCID 0000-0003-4828-4586
Melissa YeeUPMC Hillman Cancer Center, Pittsburgh, PA.
Douglas WhitePalliative Research Center (PaRC), University of Pittsburgh, Pittsburgh, PA.

Funding

VECTOR CORE FACILITYP30CA047904 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI CHRISTOPHER J. BAKKENIST · 1988 to 2026
$158.0M
Patient-centered and efficacious advance care planning in cancer: the PEACe comparative effectiveness trialR01CA235730 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SCHENKER, YAEL · 2019 to 2024
$3.1M
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
Mentored Patient Oriented Research in Improving Surrogate Decision Making for Patients with Advanced Respiratory FailureK24HL148314 · NHLBI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI Douglas B White · 2019 to 2026
$944k
NCI NIH HHS P30 CA047904NCI NIH HHS R01 CA235730NHLBI NIH HHS K24 HL148314NIA NIH HHS K24 AG054415
6 · The paper itself

Abstract

purposeGuidelines recommend advance care planning (ACP) to improve patient-centered care near the end of life (EOL), but the optimal approach is unknown. This single-blind, patient-level, randomized comparative effectiveness trial compared two patient-facing ACP interventions that are widely used but differ in costs and complexity.

methodsAdult patients with advanced solid tumors and their caregivers were recruited from academic and community oncology clinics. Participants were randomly assigned to facilitated ACP using trained nurse facilitators versus patient-directed ACP using written and web-based tools. The primary outcome was patient-reported ACP engagement (assessed at baseline and 12 weeks using a 15-item validated survey; range, 0-5; higher scores indicate higher engagement). Secondary outcomes included advance directive completion and communication about EOL wishes.

resultsA total of 400 patients enrolled (mean [SD] age, 67.9 [10.5] years; 192 women [48%]). At 12 weeks, patients in the facilitated versus patient-directed group reported higher ACP engagement (4.34 [0.78]

conclusionFacilitated ACP resulted in greater increases in ACP engagement and advance directive completion than patient-directed written and web-based materials. Although some patients with advanced cancer may engage in self-directed ACP, some may need additional facilitator support.

Indexed as

Advance Care PlanningNeoplasmsAgedFemaleHumansMaleMiddle AgedPatient-Centered Care

Identifiers

PMID40106743
PMCPMC12353131

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.