Evidence map›Paper›PMID 40318049›Full record

ArticleJournal of the American Geriatrics Society2025

Assessing the Content of Goals of Care Documentation for Hospitalized Patients With Alzheimer's Disease and Related Dementias.

Gina Piscitello, Jennifer Lingler, Katherine Ramos, Yael Schenker, Robert M Arnold, Jane Schell

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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

1 citing paper in PubMed.

  1. 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

6 authors.

Gina PiscitelloSection of Palliative Care and Medical Ethics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.ORCID 0000-0002-3958-4491
Jennifer LinglerDepartment of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, Pennsylvania, USA.
Katherine RamosDepartment of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA.
Yael SchenkerSection of Palliative Care and Medical Ethics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Robert M ArnoldBrookedale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
Jane SchellSection of Palliative Care and Medical Ethics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Funding

Research Education ComponentP30AG066468 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI C. Elizabeth Shaaban · 2020 to 2026
$29.4M
Brain CHEC-AC (Brain and Cognitive Health Equity Campaign for Allegheny County)U01NS141777 · NINDS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI JENNIFER Hagerty LINGLER, C. Elizabeth Shaaban · 2024 to 2026
$2.2M
Patient and Family Member Reactions to Biomarker-Informed ADRD DiagnosesRF1AG080591 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI GRILL, JOSHUA, LINGLER, JENNIFER HAGERTY · 2023 to 2023
$2.1M
Midcareer Investigator Award in Patient-Oriented Research: Yael Schenker, MD, MASK24AG070285 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI SCHENKER, YAEL · 2021 to 2025
$841k
A Patient-Caregiver Behavioral Intervention for Older Adults with Cancer and Mild Cognitive ImpairmentK08CA258947 · NCI · DUKE UNIVERSITY · PI Katherine Ramos · 2022 to 2026
$809k
Caregiver-assisted pain coping skills training for dementiaR61AG088938 · NIA · DUKE UNIVERSITY · PI PORTER, LAURA S · 2024 to 2025
$772k
Duke/UNC ADAR ProgramR25AG086117 · NIA · DUKE UNIVERSITY · PI BAKER, TAMARA A, MARQUINE, MARIA · 2024 to 2024
$405k
NCI NIH HHS K08 CA258947NIA NIH HHS K24 AG070285NIA NIH HHS P30 AG066468NIA NIH HHS R25 AG086117NIA NIH HHS R61 AG088938NIA NIH HHS RF1 AG080591NIH HHS Dr. Lingler was supported by P30AG066468, RF1 AG08NIH HHS Dr. Ramos was supported in part by K08CA258947, R2NIH HHS Dr. Schenker was supported by K24AG070285NINDS NIH HHS U01 NS141777
6 · The paper itself

Abstract

backgroundGoals of care (GOC) conversations are an evidence-based practice that help clarify and align patient values and preferences for medical care with treatment options. Little is known about how clinicians document the content of GOC conversations for patients with Alzheimer's disease and related dementias (AD/ADRD) in the electronic health record (EHR) and whether this may differ across hospitals. We aimed to assess the content of GOC documentation for hospitalized patients with and without AD/ADRD.

methodsWe performed a retrospective cross-sectional study to assess documented content within a standardized GOC note written for seriously ill hospitalized adult patients admitted to 21 hospitals between 2021 and 2023. Seriously ill patients had a predicted 90-day mortality greater than 30% as determined by an artificial intelligence mortality prediction score. Patients with AD/ADRD were identified using diagnostic codes placed by clinicians in the EHR.

resultsOur review of GOC documentation across 21 hospitals identified 5475 patients with GOC notes. The study sample had a median age of 76 years and was 52% male, 13% nonwhite, 81% with Medicare insurance, and 14% with AD/ADRD. Compared to patients without AD/ADRD, patients with AD/ADRD were more likely to have documentation of family presence at the GOC conversation (93% vs. 76%, p = < 0.001), a surrogate decision-maker (60% vs. 54%, p = 0.003), and patient prognosis (84% vs. 78%, p = < 0.001). Patients with AD/ADRD were less likely to have documentation of patient presence at the GOC conversation (28% vs. 64%, p = < 0.001) and patient values and preferences for medical care (65% vs. 69%, p = < 0.05).

conclusionsHospitalized patients with AD/ADRD are infrequently present in GOC conversations and less likely to have their values and preferences for medical care documented within a GOC note. Further research is needed to explore the reasons for these findings.

Indexed as

Alzheimer DiseaseDementiaDocumentationElectronic Health RecordsHospitalizationPatient Care PlanningAgedAged, 80 and overCross-Sectional StudiesFemaleHumansMaleRetrospective StudiesAlzheimer's disease and related dementiaelectronic health record documentationgoals of carenonrural hospitalsrural hospitals

Identifiers

PMID40318049
PMCPMC12353549

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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.