作者
Christopher R Manz, Yichen Zhang, Kan Chen, Qi Long, Dylan S Small, Chalanda N Evans, Corey Chivers, Susan H Regli, C William Hanson, Justin E Bekelman, Jennifer Braun, Charles AL Rareshide, Nina O’Connor, Pallavi Kumar, Lynn M Schuchter, Lawrence N Shulman, Mitesh S Patel, Ravi B Parikh
发表日期
2023/3/1
期刊
JAMA oncology
卷号
9
期号
3
页码范围
414-418
出版商
American Medical Association
简介
Importance
Serious illness conversations (SICs) between oncology clinicians and patients are associated with improved quality of life and may reduce aggressive end-of-life care. However, most patients with cancer die without a documented SIC.
Objective
To test the impact of behavioral nudges to clinicians to prompt SICs on the SIC rate and end-of-life outcomes among patients at high risk of death within 180 days (high-risk patients) as identified by a machine learning algorithm.
Design, Setting, and Participants
This prespecified 40-week analysis of a stepped-wedge randomized clinical trial conducted between June 17, 2019, and April 20, 2020 (including 16 weeks of intervention rollout and 24 weeks of follow-up), included 20 506 patients with cancer representing 41 021 encounters at 9 tertiary or community-based medical oncology clinics in a large academic health system. The current analyses were …
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CR Manz, Y Zhang, K Chen, Q Long, DS Small… - JAMA oncology, 2023