Evidence map›Paper›PMID 41998266›Full record

ArticleJournal of general internal medicine2026

Effect of Emergency Department-Initiated Video-Enhanced Advance Care Planning on Documentation and Goal-Concordant Care: A Randomized Clinical Trial.

Angelo E Volandes, Hacho Bohossian, Yuchiao Chang, Charlotta Lindvall, Michael K Paasche-Orlow, Seth Randa, Upeka Samarakoon, Tadayuki Hashimoto, Nanako Shirai, Aretha D Davis and 17 more

Registry-linked trialAbstract read
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In one paragraph

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. It is linked to trial NCT04931797 (Using the Emergency Department Visit to Promote Advance Care Planning), 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.

NCT04931797 naactive not recruitingnot on this map

Using the Emergency Department Visit to Promote Advance Care Planning

TypeinterventionalSponsorMassachusetts General HospitalRan2022 to 2026Enrolled900ConditionsEmergenciesArmsvideo decision aid, control arm ACP information sheet
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

27 authors.

Angelo E VolandesDepartment of Medicine, Dartmouth Health, Lebanon, NH, USA. angelo.e.volandes@hitchcock.org.
Hacho BohossianDepartment of Medicine, Newton-Wellesley Hospital, Newton, MA, USA.
Yuchiao ChangDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Charlotta LindvallDepartment of Supportive Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Michael K Paasche-OrlowDepartment of Medicine, Tufts Medical Center, Boston, MA, USA.
Seth RandaSchool of Medicine, University of California, San Francisco, CA, USA.
Upeka SamarakoonDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Tadayuki HashimotoDepartment of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, USA.
Nanako ShiraiHarvard Medical School, Boston, MA, USA.
Aretha D DavisACP Decisions, Newton, MA, USA.
Nathan E GoldsteinDepartment of Medicine, Dartmouth Health, Lebanon, NH, USA.
Cynthia GardeACP Decisions, Newton, MA, USA.
Gabriel A Paasche-OrlowDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Kate SciaccaDepartment of Supportive Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Karina KleinDepartment of Emergency Medicine, University of California Davis Health, Sacramento, CA, USA.
Eric HansonDepartment of Emergency Medicine, University of California Davis Health, Sacramento, CA, USA.
Allyson SageDepartment of Emergency Medicine, University of California Davis Health, Sacramento, CA, USA.
Donovan S NielsenDepartment of Emergency Medicine, University of California Davis Health, Sacramento, CA, USA.
Beth Walker-CorkeryDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Areej El-JawahriDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Michael J BarryDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Milton JoelDepartment of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Timothy Platts-MillsOphirex, Inc, Corte Madera, CA, USA.
Brigitte N DurieuxDepartment of Supportive Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Anne KwokDepartment of Informatics and Analytics, Dana-Farber Cancer Institute, Boston, MA, USA.
Katren R TylerDepartment of Emergency Medicine, University of California Davis Health, Sacramento, CA, USA.
Kei OuchiDepartment of Supportive Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.

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
NIA NIH HHS K76 AG064434
6 · The paper itself

Abstract

backgroundAdvance care planning (ACP) is widely promoted; however, it remains unclear if documentation translates to goal-concordant care aligned with patient values.

objectiveTo determine whether emergency department-initiated video-enhanced ACP increases documentation and improves goal-concordant care among decedents.

designMulticenter, parallel-group randomized trial (2022-2024, follow-up to 2025). Outcome assessors were blinded to assignment.

settingThree emergency departments.

participantsAdults aged ≥ 65 or 50-64 with serious illness.

interventionsIntervention group (a) viewed an ACP video, (b) had an ACP conversation, and (c) triggered electronic health record provider notification. Controls received usual care. MAIN MEASURES: Primary outcome was ACP documentation within 3 months. Secondary outcomes included goals-of-care preferences, ACP knowledge (1-5), engagement (1-4), and documentation at 6 months. Goal concordance used a 10-point scale (10 = perfect concordance). KEY

results598 patients (298 intervention, 300 control; mean age 73.5 ± 8.1 years; 53.7% women) were randomized. At 3 months, ACP documentation was significantly higher in the intervention group (45.6% [136/298] vs. 31.3% [94/300]; rate difference [RD] = 14.3%, 95% CI 6.6%-22.0%; P < .001), persisting at 6 months (52.3% vs. 39.3%; RD = 13.0%, 95% CI 5.1%-20.9%; P = .002). ACP knowledge (4.1 vs. 3.1; mean difference [MD] = 1.0, 95% CI 0.9-1.2; P < .001) and engagement (4.1 vs. 3.9; MD = 0.2, 95% CI 0.1-0.3; P = .004) were greater in the intervention group compared to the control. There were no differences in goals-of-care preferences between the two study arms. Among 94 decedents (53 intervention, 41 control), intervention recipients had substantially higher goal-concordance scores (median 10 [IQR 8-10] vs. 7 [IQR 3-10]; P < .001).

conclusionsVideo-enhanced ACP increased documentation rates. Among decedents, goal-concordance was higher in the intervention group, suggesting ED-initiated ACP may help align care with patient preferences.

trial registrationClinicaltrials.gov identifier: NCT04931797 (posted June 1, 2021).

Indexed as

advance care planningdecision aidsemergency medicinegeriatricsgoal-concordant caregoals of carepalliative careserious illness conversationsshared decision makingvideo decision aids

Identifiers

PMID41998266

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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.