ArticleJournal of general internal medicine2026
Does Checklist-Guided Shared Decision Making Have a Sustained Effect on Code Status Decisions Among Medical Inpatients? Long-Term Follow Up of the Randomized CLEAR Checklist Trial.
Article in Journal of general internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
16 authors.
Funding
Abstract
backgroundCode status discussions are often inadequate, omitting key information on prognosis and resuscitation risks. In the randomized controlled CLEAR trial, use of a checklist to guide shared decision-making for code status discussions improved the quality of care by reducing patients' uncertainty and increasing their satisfaction with discussions and knowledge of this topic. Moreover, a higher rate of "do-not-resuscitate" (DNR) code status preference was observed during the index hospital stay. The present analysis evaluates whether these effects were sustained over time.
objectiveTo evaluate the documented code status (primary outcome) and exploratory secondary outcomes, including patients' general knowledge about resuscitation measures after a mean follow-up time of 3.2 years, assessed by telephone interview.
designLong-term follow-up of a prospective, randomized controlled study.
participantsOf the 1954 medical inpatients in the previous CLEAR trial, 604 had died and 10 were excluded due to missing information, leaving 1340 patients for analysis (mean age 65.0 (SD ± 16.3) years, 44.1% female).
interventionsCode status discussions using a shared decision-making checklist including visual decision support addressing prognosis, resuscitation outcomes, and patient values compared to usual care. MAIN MEASURES: Last documented code status at follow-up. KEY
resultsPatients in the intervention group had a significantly higher rate of documented DNR status at follow-up compared to patients in the usual care group (251 [36.1%] vs. 191 [29.8%]; adjusted risk ratio 1.23, 95% CI 1.04 to 1.45, p = 0.02). No significant differences were observed in knowledge about resuscitation measures.
conclusionsSeveral years after a shared decision-making code status discussion, patients recalled little specific knowledge about resuscitation measures and their prognostic outcomes. However, the intervention group maintained a higher documented preference for DNR. These results highlight the need for repeated discussions, including prognosis and expected outcomes, to support informed and consistent decision-making.
Indexed as
Identifiers
41979723What OpenQuestion holds
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.