Evidence map›Paper›PMID 40729413›Full record

Trial reportAcademic emergency medicine : official journal of the Society for Academic Emergency Medicine2025

Exploring Patients' Perceptions of an Advance Care Planning Intervention in the Emergency Department: A Qualitative Study.

Youkie Shiozawa, Saaya Morton, Nanako Shirai, Hannah Oelschlager, Lucy Kiernat, Anita N Chary, Anna C Revette, Adrian Haimovich, Smit Desai, Kai-Wei Chang and 4 more

Registry-linked trialAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Academic emergency medicine : official journal of the Society for Academic Emergency Medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05209880 (An Advance Care Planning Intervention in the Emergency Department), which is not on this map. Not yet cited in PubMed.

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

NCT05209880 nacompletednot on this map

An Advance Care Planning Intervention in the Emergency Department: a Randomized Controlled Trial

TypeinterventionalSponsorBrigham and Women's HospitalRan2022 to 2024Enrolled141ConditionsCongestive Heart Failure, Metastatic Cancer, Chronic Kidney Disease Requiring Chronic Dialysis, Chronic Obstructive Pulmonary DiseaseArmsED GOAL
3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

14 authors.

Youkie ShiozawaDepartment of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.ORCID 0009-0005-6998-3724
Saaya MortonDepartment of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Nanako ShiraiHarvard Medical School, Boston, Massachusetts, USA.
Hannah OelschlagerDepartment of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Lucy KiernatDepartment of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Anita N CharyDepartment of Emergency Medicine, Baylor College of Medicine, Houston, Texas, USA.
Anna C RevetteSurvey and Data Management Core, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Adrian HaimovichDepartment of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.ORCID 0000-0002-4106-7055
Smit DesaiNortheastern University, Boston, Massachusetts, USA.
Kai-Wei ChangDepartment of Computer Science, University of California, Los Angeles, California, USA.
Shan W LiuDepartment of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA.ORCID 0000-0002-5602-3717
Maura KennedyDepartment of Emergency Medicine, Harvard Medical School, Boston, Massachusetts, USA.
Mara A SchonbergHarvard Medical School, Boston, Massachusetts, USA.
Kei OuchiDepartment of Emergency Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.ORCID 0000-0002-2723-4259

Funding

ED GOAL: An Advance Care Planning Intervention for Seriously Ill Older Adults in the Emergency DepartmentK76AG064434 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI OUCHI, KEI · 2020 to 2024
$1.3M
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
Cambia Health FoundationNIA NIH HHS K24 AG071906NIA NIH HHS K76 AG064434NIA NIH HHS K76AG064434
6 · The paper itself

Abstract

objectivesEmergency department (ED) visits offer opportunities for seriously ill patients to formulate future medical care goals, yet ED clinicians lack practical strategies for these conversations. ED GOAL, a behavioral intervention, engages seriously ill yet clinically stable older adults in the ED to address advance care planning (ACP) with their outpatient clinicians. In a randomized trial, goals-of-care documentation was significantly higher in the intervention group compared to controls after three (24.3% vs. 9.9%, p = 0.03) and 6 months (31.4% vs. 12.7%, p < 0.01). This study is a sub-analysis to learn about intervention arm participants' perceived benefits and obstacles of the intervention.

methodsWe conducted semi-structured interviews between October 2022 and August 2024 (N = 52) with intervention-arm patients aged 50+ years at three hospitals in Boston, Massachusetts. Using rapid qualitative analyses, we identified themes in intervention-arm participants' comments to open-ended questions about the intervention's benefits and obstacles to continue ACP outside the ED.

resultsOf 70 intervention-arm participants, 52 completed interviews, of which two were surrogates. ED GOAL motivated most patients to initiate ACP with outpatient clinicians and loved ones and improved the quality of conversations by clarifying patients' wishes and improving patient-clinician relations. Barriers to continuing ACP were the lack of clinician availability and patient/surrogate readiness. Those with clear care goals found the intervention less useful yet harmless.

conclusionsThe intervention provided participants with insights into actionable ACP steps. To address the lack of clinician availability, these conversations may be completed by non-physician clinicians or through non-personnel resources. Better tailored ACP interventions may improve patients' readiness.

trial registrationClinicalTrials.gov identifier: NCT05209880.

Indexed as

Advance Care PlanningEmergency Service, HospitalAgedAged, 80 and overBostonFemaleHumansInterviews as TopicMaleMiddle AgedQualitative Research

Identifiers

PMID40729413
PMCPMC12811981

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Registered trials

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.