Evidence map›Paper›PMID 42422416›Full record

ReviewCJC pediatric and congenital heart disease2026

Trigger Criteria for Advance Care Planning in Adults With Congenital Heart Disease: A Systematic Review.

Mathias Possner, Fabienne Schwitz, Niculin Zach, Tanya Karrer, James Tam, Erwin Oechslin, Isabelle Vonder Muhll, Kayla Wolofsky, David Birnie, Luc Beauchesne and 2 more

Abstract readReview
In one paragraph

Review in CJC pediatric and congenital heart disease, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Trigger Criteria for Advance-Care Planning in ACHD: The Time Is Now.CJC pediatric and congenital heart disease · 2026
    Article
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

12 authors.

Mathias PossnerDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Fabienne SchwitzDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Niculin ZachDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
Tanya KarrerMedical Library, University Library of Bern, Bern, Switzerland.
James TamSection of Cardiology, University of Manitoba, Winnipeg, Manitoba, Canada.
Erwin OechslinToronto ACHD Program, Peter Munk Cardiac Centre, Division of Cardiology, and University of Toronto, Toronto, Ontario, Canada.
Isabelle Vonder MuhllDivision of Cardiology, University of Alberta, Edmonton, Alberta, Canada.
Kayla WolofskyDivision of Palliative Medicine and General Internal Medicine, University of Toronto, Toronto, Ontario, Canada.
David BirnieDivision of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Luc BeauchesneDivision of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Andrew S MackieDivision of Cardiology, Stollery Children's Hospital, Edmonton, Alberta, Canada.
Markus SchwerzmannDepartment of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Adults with congenital heart disease (CHD) face increased risks of premature morbidity and mortality. Advance care planning (ACP) facilitates longitudinal, patient-centered care but remains underused in this population, partly due to the lack of validated trigger criteria to initiate ACP. This study aimed to systematically review the literature to identify proposed triggers to initiate ACP conversations in adults with CHD. Methods: We conducted a systematic search of MEDLINE, Embase, PsycInfo, CINAHL, Web of Science, Scopus, and the Cochrane Library from database inception to July 26, 2024. The search focused on 2 core concepts: CHD and adults, and ACP or palliative care. Two reviewers independently screened articles for inclusion and extracted potential trigger criteria for ACP initiation. Results: Of 4257 articles screened, 21 were included for data extraction. Nearly half (48%) were published between 2020 and 2024, with most (81%) appearing in cardiology journals. ACP was most often recommended during routine follow-up (15 articles, 71%), independent of defect complexity or functional status. Specific interventions (10 articles, 48%) and signs of disease progression (10 articles, 48%) were the second most frequently cited trigger criteria, followed by defect-specific triggers (7 articles, 33%). Symptom- and patient-based triggers were less frequently reported. Conclusions: This review highlights a wide range of proposed triggers and a lack of consensus on when to initiate ACP in adults with CHD. The identified triggers can inform clinical practice and serve as a foundation for developing standardized criteria. However, findings are limited by the heterogeneity among the included studies. Registration: PROSPERO CRD42024597771.

Indexed as

adult congenital heart diseaseadvance care planningpalliative careserious illness conversation

Identifiers

PMID42422416
PMCPMC13343426

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

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.