Evidence map›Paper›PMID 40271984›Full record

ArticleThe American journal of hospice & palliative care2026

Advance Care Planning Engagement of Older Adults in the Emergency Department.

Adrian D Haimovich, Kenji Numata, Justin Wolozin, Zara Foroohar, Carlo Ottanelli, Ryan C Burke, Erin K Kross, Rebecca L Sudore, Nathan I Shapiro, Mara A Schonberg and 1 more

Abstract read
In one paragraph

Article in The American journal of hospice & palliative care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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.

Adrian D HaimovichDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Kenji NumataDepartment of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA.ORCID 0000-0001-9813-5592
Justin WolozinDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Zara ForooharDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Carlo OttanelliDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.ORCID 0009-0008-7211-4855
Ryan C BurkeDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Erin K KrossDivision of Pulmonary, Critical Care, and Sleep Medicine, University of Washington, Seattle, WA, USA.ORCID 0000-0002-8206-3050
Rebecca L SudoreDivision of Geriatrics, Department of Medicine, University of California, San Francisco, CA, USA.
Nathan I ShapiroDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Mara A SchonbergSan Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
Kei OuchiDepartment of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA.

Funding

Institutional Career Development CoreKL2TR002542 · NCATS · HARVARD MEDICAL SCHOOL · PI BREDELLA, MIRIAM ANTOINETTE, RUTKOVE, SEWARD B. · 2018 to 2022
$8.7M
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
Research and mentoring program in shared decision making in the care of older adultsK24AG071906 · NIA · BETH ISRAEL DEACONESS MEDICAL CENTER · PI SCHONBERG, MARA A · 2021 to 2025
$946k
NCATS NIH HHS KL2 TR002542NIA NIH HHS K24 AG054415NIA NIH HHS K24 AG071906
6 · The paper itself

Abstract

BackgroundAdvance care planning (ACP) helps older adults make end-of-life medical decisions. While ACP discussions are associated with improved patient outcomes, overall engagement remains low in the emergency department (ED).ObjectivesThis study assessed ACP engagement in older ED patients.MethodsWe conducted a questionnaire study among adults ≥65 in a Boston ED (July-Oct 2023). Our primary outcome was ACP Engagement as measured by a validated 9-item instrument with three ACP self- efficacy and six ACP readiness questions. Secondary outcomes included participants' preferences for learning about five ACP topics in the ED-medical decision makers, what matters most, leeway and flexibility for decision makers, sharing wishes, and asking questions)-as well as their favored learning formats (eg, pamphlets, videos, clinician conversations). Each was rated on a 5-point Likert scale. We examined the relationship between ACP engagement and existing electronic health record (EHR) documentation.ResultsNinety-nine older adults participated (mean age 75.5; 53.5% women). On the 9-item ACP Engagement Survey, participants reported high overall scores with a mean of 4.1 (95% CI: 4.0-4.2). Among ACP readiness topics, 80 (81.6%) named a decision-maker; 37 (40.2%) discussed end-of-life wishes with doctors. Participants preferred ED team conversations. Among the 51 participants who reported having signed paperwork regarding end-of-life wishes, only 7 (13.7%) had forms documented in the EHR.ConclusionsAmong older adults in a large Boston-based ED, ACP engagement was high, but few patients had documentation of end-of-life wishes available in the EHR. Findings highlight the need for better ACP documentation in EDs.

Indexed as

Advance Care PlanningEmergency Service, HospitalAgedAged, 80 and overBostonDecision MakingElectronic Health RecordsFemaleHumansMaleSelf EfficacySurveys and QuestionnairesTerminal Careadvance care planningelectronic health recordemergency departmentend-of-lifegeriatricspalliative care

Identifiers

PMID40271984
PMCPMC12377290

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.