Evidence map›Paper›PMID 40411723›Full record

ArticleEuropean geriatric medicine2025

Communicating prognostic uncertainties in advanced multimorbidity: a multimethod qualitative study to co-design practice recommendations.

Simon Noah Etkind, Rosanna Fennessy, James Wang, Rhian M Simpson, Bernadette O'Neill, Stephen I G Barclay, Anna Spathis

Abstract read
In one paragraph

Article in European geriatric medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. 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

7 authors.

Simon Noah EtkindPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, East Forvie Building, Forvie Site, Addenbrookes Biomedical Campus, Robinson Way, Cambridge, CB20SZ, UK. Sde23@medschl.cam.ac.uk.ORCID http://orcid.org/0000-0003-2863-8893
Rosanna FennessyPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, East Forvie Building, Forvie Site, Addenbrookes Biomedical Campus, Robinson Way, Cambridge, CB20SZ, UK.
James WangClinical School, University of Cambridge, Cambridge, UK.
Rhian M SimpsonCambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
Bernadette O'NeillKing's College London, London, UK.
Stephen I G BarclayPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, East Forvie Building, Forvie Site, Addenbrookes Biomedical Campus, Robinson Way, Cambridge, CB20SZ, UK.
Anna SpathisPrimary Care Unit, Department of Public Health and Primary Care, University of Cambridge, East Forvie Building, Forvie Site, Addenbrookes Biomedical Campus, Robinson Way, Cambridge, CB20SZ, UK.

Funding

Addenbrooke's Charitable Trust, Cambridge University Hospitals 900382
6 · The paper itself

Abstract

purposeOlder adults with advanced multimorbidity face an uncertain future due to their unpredictable illness trajectory. Communication of such uncertainty is a core task in healthcare, but there is a limited evidence base to support communication of prognostic uncertainty in multimorbidity. We aimed to co-design clinical practice recommendations for communication of prognostic uncertainty in advanced multimorbidity, based on the lived experience and expertise of patients, carers, and healthcare professionals.

methodsMulti-method qualitative co-design study. In phase one, older adults with advanced multimorbidity, their informal carers, and health professionals participated in interviews and focus groups exploring experiences of uncertainty communication. Transcripts were analysed thematically. In phase two, attendees at two stakeholder events provided feedback on the findings and iteratively developed practice recommendations.

resultsFifteen older adults (median age 80, range 70-89), three informal carers, and 17 health professionals provided qualitative data. We then held workshops with 56 stakeholders. Participants considered that a personalised approach supported discussions of prognostic uncertainty; trusting care relationships, and regard for timing and preparation of all parties were needed. Participants agreed that discussions of uncertainty should proceed based on open and honest discussion within negotiated limits. Clinicians should signpost support and undertake parallel planning for the range of future possibilities to outline the boundaries of uncertainty.

conclusionThis study has developed recommendations for communication of prognostic uncertainty in older people with advanced multimorbidity, to support parallel planning for an unpredictable future. Implementing these recommendations, it may reduce negative impacts of uncertainty and improve care experience.

Indexed as

CommunicationMultimorbidityAgedAged, 80 and overCaregiversFemaleFocus GroupsHealth PersonnelHumansMalePrognosisQualitative ResearchUncertaintyCo-designCommunicationMultimorbidityOlder adultsUncertainty

Identifiers

PMID40411723
PMCPMC12378655

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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.