Evidence map›Paper›PMID 41467256›Full record

ArticleJournal of palliative medicine2026

Natural Language Processing to Assess Palliative Care Processes and Health Care Utilization in Seriously Ill Older Adults with Severe Trauma.

Daniel I Hoffman, Sydney Moore, Mengyuan Ruan, Masami Tabata-Kelly, Kate Sciacca, Tamryn F Gray, Stuart R Lipsitz, Christine S Ritchie, Charlotta Lindvall, Zara Cooper

Abstract read
In one paragraph

Article in Journal of palliative medicine, 2026. 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

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5 · Who and what money

Authors and funding

10 authors.

Daniel I HoffmanCenter for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Sydney MooreCenter for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Mengyuan RuanCenter for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Masami Tabata-KellyCenter for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Kate SciaccaDepartment of Supportive Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Tamryn F GrayDepartment of Supportive Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.
Stuart R LipsitzCenter for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA.
Christine S RitchieHarvard Medical School, Boston, Massachusetts, USA.
Charlotta LindvallHarvard Medical School, Boston, Massachusetts, USA.
Zara CooperCenter for Surgery and Public Health, Brigham and Women's Hospital, Boston, Massachusetts, USA.

Funding

A Layered Examination of the Patient Experience to Elucidate the Role of Palliative Care in Surgical Care for Seriously Ill Older AdultsR01AG070252 · NIA · BRIGHAM AND WOMEN'S HOSPITAL · PI COOPER, ZARA R · 2021 to 2025
$4.0M
NIA NIH HHS R01 AG070252
6 · The paper itself

Abstract

backgroundNational guidelines recommend palliative care (PC) alongside life-sustaining treatment for older adults with severe trauma. However, outcomes associated with PC for these patients are not well-defined.

objectivesTo determine frequency of inpatient PC process documentation in older adults with severe trauma and test associations with postdischarge health care utilization.

designRetrospective cohort study using electronic health record data linked to Medicare claims. SETTING/SUBJECTS: We included adults ≥66 years old admitted to a large, regional U.S. health care system with severe trauma (2016-2018) using consensus criteria for serious illness in trauma. MEASUREMENTS: Natural language processing was used to measure documentation of five inpatient PC processes: code status limitations, goals-of-care (GOC) conversations, hospice discussions, PC consultations, and health care proxy designations. Associations between PC processes and postdischarge health care utilization were tested using multivariable regression.

resultsAmong 1267 admissions, the median age was 82 years (interquartile range [IQR] 75-88), and median injury severity score (0-75, higher is worse) was 16 (IQR 9-21); ≥1 PC process was documented in 81%. Among those surviving hospitalization (87%), one-year mortality was 26%. Documentation of ≥1 PC process was not significantly associated with differences in mean hospital days (16 vs. 19), home days (306 vs. 307), emergency department visits (2.3 vs. 2.2), or intensive care unit days (0.6 vs. 0.9) at one year. PC processes were significantly associated with subsequent hospice enrollment (

conclusionsPC was not associated with reduced health care utilization in older adults after trauma but was associated with one-year hospice enrollment. GOC conversations, specialty PC, and inpatient hospice discussions had low utilization, highlighting target areas for improvements in care delivery.

Indexed as

Natural Language ProcessingPalliative CarePatient Acceptance of Health CareWounds and InjuriesAgedAged, 80 and overElectronic Health RecordsFemaleHumansMaleMedicareRetrospective StudiesUnited Statesnatural language processingpalliative careserious illnesssurgerytrauma

Identifiers

PMID41467256
PMCPMC12826804

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