Prevalence of and Factors Related to Discordance About Prognosis Between Physicians and Surrogate Decision Makers of Critically Ill Patients
Open accessAbstract
IMPORTANCE: Misperceptions about prognosis by individuals making decisions for incapacitated critically ill patients (surrogates) are common and often attributed to poor comprehension of medical information. OBJECTIVE: To determine the prevalence of and factors related to physician-surrogate discordance about prognosis in intensive care units (ICUs). DESIGN, SETTING, AND PARTICIPANTS: Mixed-methods study comprising quantitative surveys and qualitative interviews conducted in 4 ICUs at a major US medical center involving surrogate decision makers and physicians caring for patients at high risk of death from January 4, 2005, to July 10, 2009. MAIN OUTCOMES AND MEASURES: Discordance about prognosis, defined as a difference between a physician's and a surrogate's prognostic estimates of at least 20%; misunderstandings by surrogates (defined as any difference between a physician's prognostic estimate and a surrogate's best guess of that estimate); differences in belief (any difference between a surrogate's actual estimate and their best guess of the physician's estimate). RESULTS: Two hundred twenty-nine surrogate decision makers (median age, 47 [interquartile range {IQR}, 35-56] years; 68% women) and 99 physicians were involved in the care of 174 critically ill patients (median age, 60 [IQR, 47-74] years; 44% women). Physician-surrogate discordance about prognosis occurred in 122 of 229 instances (53%; 95% CI, 46.8%-59.7%). In 65 instances (28%), discordance was related to both misunderstandings by surrogates and differences in belief about the patient's prognosis; 38 (17%) were related to misunderstandings by surrogates only; 7 (3%) were related to differences in belief only; and data were missing for 12. Seventy-five patients (43%) died. Surrogates' prognostic estimates were much more accurate than chance alone, but physicians' prognostic estimates were statistically significantly more accurate than surrogates' (C statistic, 0.83 vs 0.74; absolute difference, 0.094; 95% CI, 0.024-0.163; P = .008). Among 71 surrogates interviewed who had beliefs about the prognosis that were more optimistic than that of the physician, the most common reasons for optimism were a need to maintain hope to benefit the patient (n = 34), a belief that the patient had unique strengths unknown to the physician (n = 24), and religious belief (n = 19). CONCLUSIONS AND RELEVANCE: Among critically ill patients, discordant expectations about prognosis were common between patients' physicians and surrogate decision makers and were related to misunderstandings by surrogates about physicians' assessments of patients' prognoses and differences in beliefs about patients' prognoses.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Surrogates' own prognostic estimates may have served as illocutionary acts-expressions intended to express positive attitude, optimism, or faith; highlight patients' unrecognized qualities of resilience; or counter clinicians' pessimism.
“their own prognostic estimates may also have served as “illocutionary acts”—that is, expressions distinct from comprehension with which they intended to express positive attitude, optimism, or faith; to highlight patients’ unrecognized qualities of resilience; or to counter clinicians’ pessimism (15, 34–36).”
From Effects of a Personalized Web-Based Decision Aid for Surrogate Decision Makers of Patients With Prolonged Mechanical Ventilation (2019) · cites this paper as [15]
The Discussion reports that some surrogates intentionally held optimistic estimates, and Surrogates’ Explanations for Optimism and Pessimism links optimism to faith and patients’ strengths unknown to physicians. Table 4 also records a belief that physicians were pessimistic. The paper does not establish that the estimates were intended as communicative ‘illocutionary acts’ or to counter clinicians’ pessimism; those are the citing authors’ interpretations. (LLM, conf=0.82)
Experimental — accuracy not yet measuredIneffective communication can result in the default provision of aggressive life support, which may conflict with patient preferences.
“Ineffective communication can result in the default provision of aggressive life support, which may conflict with patient preferences (15)”
From Effects of a Personalized Web-Based Decision Aid for Surrogate Decision Makers of Patients With Prolonged Mechanical Ventilation (2019) · cites this paper as [15]
The Discussion (page not provided) says that discordance about prognosis may lead to overuse of life-prolonging treatments, and the Abstract links optimistic expectations to greater use of invasive treatment. The paper does not say that ineffective communication causes aggressive life support to be provided by default or that such treatment conflicts with patients’ preferences. (LLM, conf=0.84)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
(1998) · Sage eBooks · Cited by 38,631 · see citing works
The Discovery of Grounded Theory: Strategies for Qualitative Research
Glaser, B. G., & Strauss, A. L. (2017) · Aldine (Routledge reprint) · doi:10.4324/9780203793206 · Cited by 25,789 · see citing works
DeLong, E. R., DeLong, D. M., & Clarke-Pearson, D. L. (1988) · Biometrics · doi:10.2307/2531595 · Cited by 22,649 · see citing works
(2006) · Cited by 18,730 · see citing works
Constructing Grounded Theory. A Practical Guide Through Qualitative Analysis
Boyle, C., & Barker, A. (2006) · QMiP Bulletin · doi:10.53841/bpsqmip.2006.1.2.36 · Cited by 11,842 · see citing works
The Discovery of Grounded Theory
Glaser, B. G., & Strauss, A. L. (2017) · Routledge eBooks · doi:10.4324/9780203793206-1 · Cited by 8,342 · see citing works
HUSKISSON, E. C. (1974) · The Lancet · doi:10.1016/s0140-6736(74)90884-8 · Cited by 4,533 · see citing works
Enhancing the quality and credibility of qualitative analysis.
(1999) · PubMed Central · Cited by 4,133 · see citing works
Clinical Epidemiology: A Basic Science for Clinical Medicine.
(1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-114-9-825_9 · Cited by 3,497 · see citing works
A Controlled Trial to Improve Care for Seriously III Hospitalized Patients
Connors, A. F. (1995) · JAMA · doi:10.1001/jama.274.20.1591 · Cited by 3,416 · see citing works
(2010) · Sage eBooks · doi:10.4135/9781412961288.n40 · Cited by 2,028 · see citing works
The Clinical Course of Advanced Dementia.
Mitchell, S. L., Teno, J. M., Kiely, D. K., Shaffer, M. L., Jones, R. N., Prigerson, H. G., Volicer, L., Givens, J. L., & Hamel, M. B. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0902234 · Cited by 1,618 · see citing works
Understanding the treatment preferences of seriously ill patients.
Fried, T., Bradley, E. H., Towle, V., & Allore, H. (2002) · New England Journal of Medicine · doi:10.1056/nejmsa012528 · Cited by 1,426 · see citing works
Relationship between cancer patients' predictions of prognosis and their treatment preferences
Weeks, J. C. (1998) · JAMA · doi:10.1001/jama.279.21.1709 · Cited by 1,319 · see citing works
Advance Directives and Outcomes of Surrogate Decision Making before Death
Silveira, M. J., Kim, S. Y. H., & Langa, K. M. (2010) · New England Journal of Medicine · doi:10.1056/nejmsa0907901 · Cited by 1,298 · see citing works
Giacomini, M. K., Cook, D. J., & for the Evidence-Based Medicine Working Group (2000) · JAMA · doi:10.1001/jama.284.3.357 · Cited by 931 · see citing works
Personal contact, individuation, and the better-than-average effect.
Alicke, M. D., Klotz, M. L., Breitenbecher, D. L., Yurak, T. J., & Vredenburg, D. S. (1995) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.68.5.804 · Cited by 914 · see citing works
Watson, K. B. (2014) · Springer eBooks · doi:10.1007/978-94-007-0753-5_291 · Cited by 890 · see citing works
Clinical Epidemiology - a basic science for clinical medicine
HOFFBRAND, B. I. (1992) · Postgraduate Medical Journal · doi:10.1136/pgmj.68.806.987-a · Cited by 780 · see citing works
Simple tools for understanding risks: from innumeracy to insight
Gigerenzer, G., & Edwards, A. (2003) · BMJ · doi:10.1136/bmj.327.7417.741 · Cited by 770 · see citing works
Azoulay, E., Chevret, S., Leleu, G., Pochard, F., Barboteu, M., Adrie, C., Canoui, P., Le Gall, J. R., & Schlemmer, B. (2000) · Critical Care Medicine · doi:10.1097/00003246-200008000-00061 · Cited by 746 · see citing works
Shared Decision Making in ICUs
Kon, A. A., Davidson, J. E., Morrison, W. E., Danis, M., & White, D. B. (2015) · Critical Care Medicine · doi:10.1097/ccm.0000000000001396 · Cited by 574 · see citing works
Self-citationUnderstanding of Prognosis Among Parents of Children Who Died of Cancer
Wolfe, J., Klar, N. S., Grier, H. E., Duncan, J., Salem-Schatz, S. R., Emanuel, E. J., & Weeks, J. C. (2000) · JAMA · doi:10.1001/jama.284.19.2469 · Cited by 466 · see citing works
You, J. J., Downar, J., Fowler, R. A., Lamontagne, F., Ma, I. W. Y., Jayaraman, D., Kryworuchko, J., Strachan, P. H., Ilan, R., Nijjar, A. P., et al. (2015) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2014.7732 · Cited by 422 · see citing works
Expectations and outcomes of prolonged mechanical ventilation*
Cox, C. E., Martinu, T., Sathy, S. J., Clay, A. S., Chia, J., Gray, A. L., Olsen, M. K., Govert, J. A., Carson, S. S., & Tulsky, J. A. (2009) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181ab86ed · Cited by 319 · see citing works
Mack, J. W., Cook, E. F., Wolfe, J., Grier, H. E., Cleary, P. D., & Weeks, J. C. (2007) · Journal of Clinical Oncology · doi:10.1200/jco.2006.08.3170 · Cited by 187 · see citing works
Decision‐Making and Outcomes of Prolonged ICU Stays in Seriously Ill Patients
Teno, J. M., Fisher, E., Hamel, M. B., Wu, A. W., Murphy, D. J., Wenger, N. S., Lynn, J., & Harrell, F. E. (2000) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2000.tb03144.x · Cited by 182 · see citing works
Surrogate Decision Makers' Interpretation of Prognostic Information: A Mixed-Methods Study
Zier, L. S., Sottile, P. D., Hong, S. Y., Weissfield, L. A., & White, D. B. (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-156-5-201203060-00008 · Cited by 171 · see citing works
Self-citationSulmasy, D. P., Astrow, A. B., He, M. K., Seils, D. M., Meropol, N. J., Micco, E., & Weinfurt, K. P. (2010) · Cancer · doi:10.1002/cncr.25201 · Cited by 159 · see citing works
Zier, L. S., Burack, J. H., Micco, G., Chipman, A. K., Frank, J. A., Luce, J. M., & White, D. B. (2008) · Critical Care Medicine · doi:10.1097/ccm.0b013e318180ddf9 · Cited by 129 · see citing works
Self-citationSurrogate Decision Makers' Responses to Physicians' Predictions of Medical Futility
Zier, L. S., Burack, J. H., Micco, G. P., Chipman, A. K., Frank, J. A., & White, D. B. (2009) · CHEST Journal · doi:10.1378/chest.08-2753 · Cited by 106 · see citing works
Self-citationChar, S. J. L., Evans, L. R., Malvar, G. L., & White, D. B. (2010) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201002-0262oc · Cited by 101 · see citing works
Self-citationSchenker, Y., White, D. B., Crowley‐Matoka, M., Dohan, D. P., Tiver, G. A., & Arnold, R. M. (2013) · Journal of Palliative Medicine · doi:10.1089/jpm.2012.0331 · Cited by 89 · see citing works
Self-citationIntensive care decision making in the seriously ill and elderly*
Lloyd, C. B., Nietert, P. J., & Silvestri, G. A. (2004) · Critical Care Medicine · doi:10.1097/01.ccm.0000115636.29294.2f · Cited by 87 · see citing works
Holland, J. C. (1989) · Journal of Clinical Oncology · doi:10.1200/jco.1989.7.5.557 · Cited by 71 · see citing works
APACHE II scoring to predict outcome in post-cardiac arrest
Donnino, M. W., Salciccioli, J. D., Dejam, A., Giberson, T. A., Giberson, B., Cristia, C., Gautam, S., & Cocchi, M. N. (2012) · Resuscitation · doi:10.1016/j.resuscitation.2012.10.024 · Cited by 68 · see citing works
The Clinical Course of Advanced Dementia
Genao, L., White, H., & Twersky, J. (2010) · New England Journal of Medicine · doi:10.1056/nejmc0911058 · Cited by 32 · see citing works
Advance Directives and Outcomes of Surrogate Decision Making Before Death
&NA; (2010) · Survey of Anesthesiology · doi:10.1097/sa.0b013e3181f21fb0 · Cited by 27 · see citing works
Expectations and outcomes of prolonged mechanical ventilation
Cox, C. E. (2010) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181d8be6f · Cited by 23 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
A randomized trial of a family-support intervention in intensive care units
White, D. B., Angus, D. C., Shields, A.-M., Buddadhumaruk, P., Pidro, C., Paner, C., Chaitin, E., Chang, C.-C. H., Pike, F., Weissfeld, L., et al. (2018) · New England Journal of Medicine · doi:10.1056/nejmoa1802637 · Cited by 524 · see citing works
Self-citationDetsky, M. E., Harhay, M. O., Bayard, D. F., Delman, A. M., Buehler, A. E., Kent, S. A., Ciuffetelli, I. V., Cooney, E. L., Gabler, N. B., Ratcliffe, S. J., et al. (2017) · JAMA · doi:10.1001/jama.2017.4078 · Cited by 191 · see citing works
Time-limited trial of intensive care treatment: an overview of current literature
Vink, E. E., Azoulay, É., Caplan, A. L., Kompanje, E. J. O., & Bakker, J. (2018) · Intensive Care Medicine · doi:10.1007/s00134-018-5339-x · Cited by 164 · see citing works
Cox, C. E., White, D. B., Hough, C. L., Jones, D. M., Kahn, J. M., Olsen, M. K., Lewis, C. L., Hanson, L. C., & Carson, S. S. (2019) · Annals of Internal Medicine · doi:10.7326/m18-2335 · Cited by 152 · see citing works
“Ineffective communication can result in the default provision of aggressive life support, which may conflict with patient preferences (15) and lead to psychological distress among family members (16).”
Self-citationModes of Death Within a Children’s Hospital
Trowbridge, A. C., Walter, J. K., McConathey, E. M., Morrison, W. E., & Feudtner, C. (2018) · PEDIATRICS · doi:10.1542/peds.2017-4182 · Cited by 150 · see citing works
Mack, J. W., Fasciano, K. M., & Block, S. D. (2018) · Journal of Clinical Oncology · doi:10.1200/jco.2018.78.2128 · Cited by 135 · see citing works
Withdrawal of Life-supporting Treatment in Severe Traumatic Brain Injury
Williamson, T. L., Ryser, M. D., Ubel, P. A., Abdelgadir, J., Spears, C. A., Liu, B., Komisarow, J. M., Lemmon, M. E., Elsamadicy, A. A., & Lad, S. P. (2020) · JAMA Surgery · doi:10.1001/jamasurg.2020.1790 · Cited by 129 · see citing works
Association Between Immigrant Status and End-of-Life Care in Ontario, Canada
Yarnell, C. J., Fu, L., Manuel, D. G., Tanuseputro, P., Stukel, T. A., Pinto, R. L., Scales, D. C., Laupacis, A., & Fowler, R. (2017) · JAMA · doi:10.1001/jama.2017.14418 · Cited by 128 · see citing works
Seaman, J. B., Arnold, R. M., Scheunemann, L. P., & White, D. B. (2017) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201612-965oi · Cited by 76 · see citing works
Self-citationThe trajectory of very old critically ill patients
Guidet, B., Vallet, H., Flaatten, H. K., Joynt, G. M., Bagshaw, S. M., Leaver, S. K., Beil, M., Du, B., Forte, D. N., Angus, D. C., et al. (2024) · Intensive Care Medicine · doi:10.1007/s00134-023-07298-z · Cited by 76 · see citing works
Conflict Management in the ICU
Kayser, J. B., & Kaplan, L. J. (2020) · Critical Care Medicine · doi:10.1097/ccm.0000000000004440 · Cited by 63 · see citing works
Addressing spirituality during critical illness: A review of current literature
Gordon, B., Keogh, M., Davidson, Z. A., Griffiths, S., Sharma, V., Marin, D. B., Mayer, S. A., & Dangayach, N. S. (2018) · Journal of Critical Care · doi:10.1016/j.jcrc.2018.01.015 · Cited by 60 · see citing works
Neurologic Outcome After Prematurity: Perspectives of Parents and Clinicians
Lemmon, M. E., Huffstetler, H. E., Barks, M. C., Kirby, C., Katz, M., Ubel, P. A., Docherty, S. L., & Brandon, D. (2019) · PEDIATRICS · doi:10.1542/peds.2018-3819 · Cited by 60 · see citing works
Prognostication and shared decision making in neurocritical care
Goostrey, K. J., & Muehlschlegel, S. (2022) · BMJ · doi:10.1136/bmj-2021-060154 · Cited by 55 · see citing works
Is There Hope? Is She There? How Families and Clinicians Experience Severe Acute Brain Injury
Schutz, R. E. C., Coats, H., Engelberg, R. A., Curtis, J. R., & Creutzfeldt, C. J. (2016) · Journal of Palliative Medicine · doi:10.1089/jpm.2016.0286 · Cited by 54 · see citing works
Self-citationKiker, W. A., Voumard, R. R., Andrews, L. I. B., Holloway, R. G., Brumback, L. C., Engelberg, R. A., Curtis, J. R., & Creutzfeldt, C. J. (2021) · JAMA Network Open · doi:10.1001/jamanetworkopen.2021.28991 · Cited by 53 · see citing works
Self-citationIntegrating Function‐Directed Treatments into Palliative Care
Cheville, A. L., Morrow, M. M. B., Smith, S. R., & Basford, J. R. (2017) · PM&R · doi:10.1016/j.pmrj.2017.07.073 · Cited by 54 · see citing works
Wilson, M. E., Dobler, C. C., Zubek, L., Gajic, O., Talmor, D. S., Curtis, J. R., Hinds, R. F., Banner‐Goodspeed, V., Mueller, A., Rickett, D. M., et al. (2019) · CHEST Journal · doi:10.1016/j.chest.2019.02.404 · Cited by 52 · see citing works
Self-citationUnited States Best Practice Guidelines for Primary Palliative Care in the Emergency Department
Loffredo, A. J., Chan, G. K., Wang, D. H., Goett, R. R., Isaacs, E., Pearl, R., Rosenberg, M. S., Aberger, K., & Lamba, S. (2021) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2021.05.021 · Cited by 45 · see citing works
Zante, B., Erne, K., Grossenbacher, J., Camenisch, S. A., Schefold, J. C., & Jeitziner, M. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03468-9 · Cited by 44 · see citing works
Goals-of-care decision aid for critically ill patients with TBI
Muehlschlegel, S., Hwang, D. Y., Flahive, J., Quinn, T. V., Lee, C., Moskowitz, J., Goostrey, K. J., Jones, K., Pach, J. J., Knies, A. K., et al. (2020) · Neurology · doi:10.1212/wnl.0000000000009770 · Cited by 43 · see citing works
Time-Limited Trials for Patients With Critical Illness
Kruser, J. M., Nadig, N. R., Viglianti, E. M., Clapp, J. T., Secunda, K. E., & Halpern, S. D. (2023) · CHEST Journal · doi:10.1016/j.chest.2023.12.014 · Cited by 41 · see citing works
Certified Patient Decision Aids: Solving Persistent Problems with Informed Consent Law
Pope, T. M. (2017) · The Journal of Law Medicine & Ethics · doi:10.1177/1073110517703097 · Cited by 41 · see citing works
The Intersection of Oncology Prognosis and Cancer Rehabilitation
Smith, S. R., & Zheng, J. Y. (2017) · Current Physical Medicine and Rehabilitation Reports · doi:10.1007/s40141-017-0150-0 · Cited by 41 · see citing works
White, D. B., Carson, S. S., Anderson, W. G., Steingrub, J. S., Bird, G., Curtis, J. R., Matthay, M. A., Peterson, M. W., Buddadhumaruk, P., Shields, A. M., et al. (2019) · Critical Care Medicine · doi:10.1097/ccm.0000000000003807 · Cited by 40 · see citing works
Self-citationNew perspectives on substituted relational autonomy for shared decision-making in critical care
Grignoli, N., Bernardo, V. D., & Malacrida, R. (2018) · Critical Care · doi:10.1186/s13054-018-2187-6 · Cited by 39 · see citing works
Voumard, R. R., Kiker, W. A., Dugger, K. M., Engelberg, R. A., Borasio, G. D., Curtis, J. R., Jox, R. J., & Creutzfeldt, C. J. (2021) · Critical Care Medicine · doi:10.1097/ccm.0000000000004947 · Cited by 39 · see citing works
Self-citationArnolds, M., Xu, L. J., Hughes, P., McCoy, J., & MEADOW, W. L. (2018) · The Journal of Pediatrics · doi:10.1016/j.jpeds.2017.12.050 · Cited by 38 · see citing works
Waller, A. E., Sanson‐Fisher, R., Nair, B., & Evans, T. J. (2019) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2019.09.003 · Cited by 38 · see citing works
Torke, A. M., Fitchett, G. A., Maiko, S. M., Burke, E. S., Slaven, J. E., Watson, B. N., Ivy, S. S., & Monahan, P. O. (2019) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2019.09.006 · Cited by 38 · see citing works
Addressing Futility: A Practical Approach
Kopar, P. K., Visani, A. V., Squirrell, K., & Brown, D. (2022) · Critical Care Explorations · doi:10.1097/cce.0000000000000706 · Cited by 37 · see citing works
Timing of Intubation in Acute Respiratory Failure Associated With Sepsis: A Mixed Methods Study
Bauer, P. R., Kumbamu, A., Wilson, M. E., Pannu, J. K., Egginton, J. S., Kashyap, R., & Gajic, O. (2017) · Mayo Clinic Proceedings · doi:10.1016/j.mayocp.2017.07.001 · Cited by 35 · see citing works
Carlini, J., Bahudin, D., Michaleff, Z. A., Plunkett, E., Shé, É. N., Clark, J. M., & Cardona, M. (2021) · European Geriatric Medicine · doi:10.1007/s41999-021-00549-6 · Cited by 36 · see citing works
Fleming, V., Prasad, A., Ge, C., Crawford, S. L., Meraj, S., Hough, C. L., Lo, B., Carson, S. S., Steingrub, J. S., White, D. B., et al. (2023) · Critical Care · doi:10.1186/s13054-023-04693-2 · Cited by 35 · see citing works
Self-citationTang, S. T., Huang, C.-C., Hu, T., Lo, M.-L., Chou, W., Chuang, L., & Chiang, M.-C. (2020) · Critical Care Medicine · doi:10.1097/ccm.0000000000004703 · Cited by 35 · see citing works
Chen, C., Michaels, J., & Meeker, M. A. (2020) · Journal of Palliative Care · doi:10.1177/0825859719874767 · Cited by 34 · see citing works
Pasricha, V., Gorman, D., Laothamatas, K., Bhardwaj, A., Ganta, N., & Mikkelsen, M. E. (2020) · ATS Scholar · doi:10.34197/ats-scholar.2019-0006oc · Cited by 34 · see citing works
Do We Know What We Mean? An Examination of the Use of the Phrase “Goals of Care” in the Literature
Edmonds, K. P., & Ajayi, T. A. (2019) · Journal of Palliative Medicine · doi:10.1089/jpm.2019.0059 · Cited by 32 · see citing works
George, L. S., Matsoukas, K., McFarland, D. C., Bowers, J. M., Doherty, M. J., Kwon, Y. S., Atkinson, T. M., Kozlov, E., Saraiya, B., Prigerson, H. G., et al. (2021) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2021.09.002 · Cited by 32 · see citing works
Parent understanding of the risk of future limitations secondary to pediatric cancer treatment
Greenzang, K. A., Cronin, A. M., Kang, T. I., & Mack, J. W. (2018) · Pediatric Blood & Cancer · doi:10.1002/pbc.27020 · Cited by 31 · see citing works
Cox, C. E., Ashana, D. C., Riley, I. L., Olsen, M. K., Casarett, D., Haines, K., O’Keefe, Y. A., Al-Hegelan, M. S., Harrison, R. W., Naglee, C., et al. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2023.49666 · Cited by 30 · see citing works
Shared Decision Making in Neurocritical Care
Khan, M., & Muehlschlegel, S. (2018) · Neurosurgery Clinics of North America · doi:10.1016/j.nec.2017.11.009 · Cited by 28 · see citing works
George, L. S., Balboni, T. A., Maciejewski, P. K., Epstein, A. S., & Prigerson, H. G. (2019) · Cancer · doi:10.1002/cncr.32575 · Cited by 28 · see citing works
Prognostication in Serious Illness
Martin, E. J., & Widera, E. (2020) · Medical Clinics of North America · doi:10.1016/j.mcna.2019.12.002 · Cited by 27 · see citing works
Concerns of surrogate decision makers for patients with acute brain injury
Hwang, D. Y., Knies, A. K., Mampre, D. M., Kolenikov, S., Schalk, M., Hammer, H., White, D. B., Holloway, R. G., Sheth, K. N., & Fraenkel, L. (2020) · Neurology · doi:10.1212/wnl.0000000000009406 · Cited by 27 · see citing works
Self-citationEthics and the 2018 Practice Guideline on Disorders of Consciousness
Peterson, A. H., Young, M. J., & Fins, J. J. (2022) · Neurology · doi:10.1212/wnl.0000000000200301 · Cited by 27 · see citing works
Unpacking cancer patients' preferences for information about their care
Ellis, E. M., & Varner, A. (2017) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2017.1357666 · Cited by 26 · see citing works
Lumbar puncture position influences intracranial pressure
Pedersen, S. H., Andresen, M., Lilja‐Cyron, A., Petersen, L. G., & Juhler, M. (2021) · Acta Neurochirurgica · doi:10.1007/s00701-021-04813-3 · Cited by 26 · see citing works
Yamamoto, K., Yonekura, Y., Hayama, J., Matsubara, T., Misumi, H., & Nakayama, K. (2021) · SAGE Open Nursing · doi:10.1177/23779608211038845 · Cited by 26 · see citing works
Loizeau, A., Shaffer, M. L., Habtemariam, D. A., Hanson, L. C., Volandes, A. E., & Mitchell, S. L. (2018) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2018.1413 · Cited by 25 · see citing works
Appraisal of Health States Worse Than Death in Patients With Acute Stroke
Everett, E. A., Everett, W., Brier, M. R., & White, P. (2020) · Neurology Clinical Practice · doi:10.1212/cpj.0000000000000856 · Cited by 24 · see citing works
Seaman, J. B., Arnold, R. M., Buddadhumaruk, P., Shields, A.-M., Gustafson, R. M., Felman, K., Newdick, W., SanPedro, R., Mackenzie, S., Morse, J. Q., et al. (2018) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201803-157sd · Cited by 22 · see citing works
Self-citationBatten, J. N., Kruse, K. E., Kraft, S. A., Fishbeyn, B., & Magnus, D. C. (2019) · Critical Care Medicine · doi:10.1097/ccm.0000000000003614 · Cited by 22 · see citing works
Incidence and Risk Model Development for Severe Tachypnea Following Terminal Extubation
Fehnel, C. R., de la Hoz, M. Á. A., Celi, L. A., Campbell, M., Hanafy, K. A., Nozari, A., White, D. B., & Mitchell, S. L. (2020) · CHEST Journal · doi:10.1016/j.chest.2020.04.027 · Cited by 22 · see citing works
Self-citationPalliative Care of the Patient with Dementia
Malhi, R. K. S., McElveen, J. L., & O’Donnell, L. (2021) · Delaware Journal of Public Health · doi:10.32481/djph.2021.09.012 · Cited by 22 · see citing works
Oppenheim, I. M., Lee, E. M., Vasher, S. T., Zaeh, S. E., Hart, J. L., & Turnbull, A. E. (2020) · JAMA Network Open · doi:10.1001/jamanetworkopen.2020.1945 · Cited by 22 · see citing works
Lo, M.-L., Huang, C.-C., Hu, T., Chou, W., Chuang, L., Chiang, M.-C., Wen, F., & Tang, S. T. (2020) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2020.07.002 · Cited by 22 · see citing works
Lemmon, M. E., Barks, M. C., Bernstein, S. M., Davis, J. K., Jiao, M. G., Kaye, E. C., Glass, H. C., Brandon, D., & Ubel, P. A. (2022) · Annals of Neurology · doi:10.1002/ana.26457 · Cited by 21 · see citing works
Dionne-Odom, J. N., Ejem, D., Azuero, A., Taylor, R. A., Rocque, G. B., Turkman, Y., Thompson, M. A., Knight, S. J., Martin, M. Y., & Bakitas, M. A. (2018) · Journal of Palliative Medicine · doi:10.1089/jpm.2018.0148 · Cited by 24 · see citing works
Optimism bias in understanding neonatal prognoses
Nayak, B., Moon, J., Kim, M., Fischhoff, B., & Haward, M. F. (2020) · Journal of Perinatology · doi:10.1038/s41372-020-00773-1 · Cited by 20 · see citing works
A Team-Based Early Action Protocol to Address Ethical Concerns in the Intensive Care Unit
Pavlish, C., Henriksen, J., Brown‐Saltzman, K., Robinson, E. M., Warda, U. S., Farra, C., Chen, B. C., & Jakel, P. (2020) · American Journal of Critical Care · doi:10.4037/ajcc2020915 · Cited by 20 · see citing works
Palliative, Ethics, and End-of-Life Care Issues in the Cancer Patient
Riches, J. C., & Voigt, L. P. (2020) · Critical Care Clinics · doi:10.1016/j.ccc.2020.08.005 · Cited by 19 · see citing works
Health-related expectations of the chronically critically ill: a multi-perspective qualitative study
Howard, A. F., Crowe, S., Choroszewski, L., Kovatch, J., Haynes, A. J., Ford, J. S., Beck, S. M., & Haljan, G. J. (2021) · BMC Palliative Care · doi:10.1186/s12904-020-00696-w · Cited by 18 · see citing works
A Survey to Assess Primary Care Physician Awareness of Complications Following Critical Illness
Liou, A. A., Schweickert, W. D., Files, D. C., & Bakhru, R. N. (2023) · Journal of Intensive Care Medicine · doi:10.1177/08850666231164303 · Cited by 17 · see citing works
Team-family conflicts over end-of-life decisions in ICU: A survey of French physicians’ beliefs
Giabicani, M., Arditty, L., Mamzer, M., Fournel, I., Ecarnot, F., Meunier‐Beillard, N., Bruneel, F., Weiss, E., Spranzi, M., Rigaud, J., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0284756 · Cited by 18 · see citing works
Miranda, S. P., Morris, R., Rabas, M., Creutzfeldt, C. J., & Cooper, Z. R. (2023) · Neurocritical Care · doi:10.1007/s12028-023-01764-8 · Cited by 18 · see citing works
Bailoor, K., Valley, T. S., Perumalswami, C. R., Shuman, A. G., Vries, R. G. D., & Zahuranec, D. B. (2018) · AJOB Empirical Bioethics · doi:10.1080/23294515.2018.1462273 · Cited by 18 · see citing works
Mistraletti, G., Mezzetti, A., Anania, S., Maddalena, A. I., Negro, S. D., Giusti, G. D., Gili, A., Iacobone, E., Pulitanò, S., Conti, G., et al. (2019) · Contemporary Clinical Trials · doi:10.1016/j.cct.2019.105847 · Cited by 16 · see citing works
Shared Decision-Making Communication and Prognostic Misunderstanding in the ICU
Vick, J. B., Berger, B., Ubel, P. A., Cox, C. E., You, H., Ma, J. E., Haverfield, M. C., Hammill, B. G., Carson, S. S., Hough, C. L., et al. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.39715 · Cited by 16 · see citing works
Self-citationForth, F. A., Hammerle, F., König, J., Urschitz, M. S., Neuweiler, P., Mildenberger, E., & Kidszun, A. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.0105 · Cited by 16 · see citing works
Leiter, N., Motta, M., Reed, R. M., Adeyeye, T., Wiegand, D. L.-M., Shah, N. G., Verceles, A. C., & Netzer, G. (2017) · Critical Care Medicine · doi:10.1097/ccm.0000000000002887 · Cited by 16 · see citing works
Strategies to Support Surrogate Decision Makers of Patients With Chronic Critical Illness
White, D. B. (2016) · JAMA · doi:10.1001/jama.2016.8691 · Cited by 15 · see citing works
Self-citationThe paradox of workplace violence in the intensive care unit: a focus group study
Sjöberg, F., Salzmann‐Erikson, M., Åkerman, E., Joelsson‐Alm, E., & Schandl, A. R. (2024) · Critical Care · doi:10.1186/s13054-024-05028-5 · Cited by 14 · see citing works
Rysavy, M. A. (2018) · Clinics in Perinatology · doi:10.1016/j.clp.2018.01.009 · Cited by 14 · see citing works
Turnbull, A. E., Chessare, C. M., Coffin, R. K., & Needham, D. M. (2019) · PLoS ONE · doi:10.1371/journal.pone.0211531 · Cited by 14 · see citing works
Brooks, L. A., Manias, E., & Bloomer, M. J. (2023) · Australian Critical Care · doi:10.1016/j.aucc.2023.04.007 · Cited by 13 · see citing works
Insurance Type and Withdrawal of Life-Sustaining Therapy in Critically Injured Trauma Patients
Hoit, G., Wijeysundera, D. N., Hamad, D. M., Nauth, A., Atrey, A., Halai, M. M., Walser, E., Nikouline, A., Nathens, A. B., & Khoshbin, A. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.21711 · Cited by 13 · see citing works
Butler, R. A., Seaman, J. B., Felman, K., Stonehouse, W., Pedro, R. S., Morse, J. Q., Chang, C.-C. H., Lincoln, T. E., Reynolds, C. F., Landefeld, S., et al. (2024) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202405-0931oc · Cited by 14 · see citing works
Self-citationUdelsman, B. V., Govea, N., Cooper, Z. R., Chang, D. C., Bader, A. M., & Meyer, M. J. (2019) · Surgery · doi:10.1016/j.surg.2019.08.013 · Cited by 13 · see citing works
Escalation and Withdrawal of Treatment for Patients on Extracorporeal Membrane Oxygenation
Hadler, R. A., Clapp, J. T., Chung, J. J., Gutsche, J. T., & Fleisher, L. A. (2021) · Annals of Surgery · doi:10.1097/sla.0000000000004838 · Cited by 13 · see citing works
Jaffa, M., Kirsch, H. L., Creutzfeldt, C. J., Guanci, M. M., Hwang, D. Y., LeTavec, D., Mahanes, D., Natarajan, G., Steinberg, A., Zahuranec, D. B., et al. (2023) · Neurocritical Care · doi:10.1007/s12028-023-01796-0 · Cited by 13 · see citing works
Biobanking in the Pediatric Critical Care Setting: Adolescent/Young Adult Perspectives
Paquette, E., Derrington, S. F., Shukla, A., Sinha, N., Oswald, S., Sorce, L. R., & Michelson, K. N. (2018) · Journal of Empirical Research on Human Research Ethics · doi:10.1177/1556264618782231 · Cited by 13 · see citing works
Surrogates’ and Researchers’ Assessments of Prehospital Frailty in Critically Ill Older Adults
Hope, A. A., Munoz, M., Hsieh, S.-J. J., & Gong, M. N. (2019) · American Journal of Critical Care · doi:10.4037/ajcc2019285 · Cited by 13 · see citing works
Communication With Family Caregivers in the Intensive Care Unit
Azoulay, É., Kentish‐Barnes, N., & Nelson, J. E. (2016) · JAMA · doi:10.1001/jama.2016.5637 · Cited by 13 · see citing works
Robertsen, A., Helseth, E., & Førde, R. (2021) · BMC Medical Ethics · doi:10.1186/s12910-021-00612-8 · Cited by 12 · see citing works
Tolsa, L., Jones, L., Michel, P., Borasio, G. D., Jox, R. J., & Voumard, R. R. (2022) · Brain Sciences · doi:10.3390/brainsci12111591 · Cited by 12 · see citing works
Cognitive Biases and Shared Decision Making in Acute Brain Injury
Steinberg, A., & Fischhoff, B. (2023) · Seminars in Neurology · doi:10.1055/s-0043-1775596 · Cited by 12 · see citing works
Lai, D., Ling, R. R., Michel, C., Hwang, D., Parikh, T., Planche, Y., Ueno, R., Pilcher, D. V., & Subramaniam, A. (2025) · Critical Care Medicine · doi:10.1097/ccm.0000000000006663 · Cited by 12 · see citing works
Chou, W., Huang, C.-C., Hu, T., Chuang, L., Chiang, M.-C., & Tang, S. T. (2021) · Journal of Palliative Medicine · doi:10.1089/jpm.2021.0304 · Cited by 12 · see citing works
Waller, A. E., Sanson‐Fisher, R., Brown, S. D., Wall, L., & Walsh, J. (2018) · Supportive Care in Cancer · doi:10.1007/s00520-018-4226-x · Cited by 12 · see citing works
Kiker, W. A., Voumard, R. R., Plinke, W., Longstreth, W. T., Curtis, J. R., & Creutzfeldt, C. J. (2022) · Neurocritical Care · doi:10.1007/s12028-022-01501-7 · Cited by 12 · see citing works
Self-citationCounseling parents of premature neonates on neuroimaging findings
Bernstein, S. M., Canfora, M., & Lemmon, M. E. (2021) · Seminars in Perinatology · doi:10.1016/j.semperi.2021.151474 · Cited by 11 · see citing works
Sigler, L. E., Althouse, A. D., Thomas, T. H., Arnold, R. M., White, D., Smith, T. J., Chu, E., Rosenzweig, M., Smith, K. J., & Schenker, Y. (2021) · JCO Oncology Practice · doi:10.1200/op.21.00573 · Cited by 11 · see citing works
Self-citationEnzinger, A. C., Uno, H., McCleary, N. J., Frank, E., Sanoff, H. K., Loon, K. V., Matin, K., Bullock, A. J., Cronin, C. M., Bagley, J., et al. (2020) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2020.07.025 · Cited by 11 · see citing works
Smirdec, M., Jourdain, M., Guastella, V., Lambert, C., Richard, J., Argaud, L., Jaber, S., Klouche, K., Médard, A., Reignier, J., et al. (2020) · Critical Care · doi:10.1186/s13054-020-03402-7 · Cited by 10 · see citing works
Kostick, K. M., Kalwani, L., Torgerson, L. N., Muñoz, K. A., Sanchez, C. E., Storch, E. A., Blumenthal-Barby, J. S. S., & Lázaro‐Muñoz, G. (2023) · Stereotactic and Functional Neurosurgery · doi:10.1159/000530694 · Cited by 9 · see citing works
Hendershot, K. A., Elias, M. N., Taylor, B. L., Wahlster, S., & Creutzfeldt, C. J. (2023) · Current Treatment Options in Neurology · doi:10.1007/s11940-023-00778-z · Cited by 9 · see citing works
Kelly, D. N., Barrett, J. A., Brand, G., Leech, M. T., & Rees, C. E. (2024) · Australian Critical Care · doi:10.1016/j.aucc.2024.02.007 · Cited by 9 · see citing works
Mobile App–Facilitated Collaborative Palliative Care Intervention for Critically Ill Older Adults
Cox, C. E., Ashana, D. C., Dempsey, K., Olsen, M. K., Parish, A., Casarett, D., Johnson, K. S., Haines, K., Naglee, C., Katz, J. N., et al. (2024) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2024.6838 · Cited by 9 · see citing works
Rosenwohl-Mack, S., Dohan, D. P., Matthews, T., Batten, J. N., & Dzeng, E. W. (2021) · Journal of Medical Ethics · doi:10.1136/medethics-2020-106690 · Cited by 9 · see citing works
- Authors
- White, D. B., Ernecoff, N., Buddadhumaruk, P., Hong, S., Weissfeld, L., Curtis, J. R., Luce, J. M., & Lo, B.
- Affiliations
- University of Pittsburgh (US)
- Statistics Collaborative (US)
- University of Washington (US)
- University of California, San Francisco (US)
- Corresponding author
- White, Douglas B.
- ORCID
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2016-05-17
- Volume
- 315
- Issue
- 19
- Pages
- 2086
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- OpenAlex
- W2407608263
- Cited by
- 232
- References
- 39
- Citations by year
- 2026: 15 · 2025: 15 · 2024: 21 · 2023: 28 · 2022: 17 · 2021: 28 · 2020: 31 · 2019: 24 · 2018: 25 · 2017: 20 · 2016: 7
- FWCI
- 25.12
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health
- National Heart, Lung, and Blood Institute (R01HL094553)
- National Center for Research Resources (KL2RR024130)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Health Professions › General Health Professions › Ethics in medical practice
- Health Sciences › Health Professions › Radiological and Ultrasound Technology › Family and Patient Care in Intensive Care Units
- Keywords
- prognosis, surrogate decision makers, critically ill patients, intensive care unit, physician communication, end-of-life decisions, prognostic accuracy, advance care planning, physician-patient communication
- MeSH terms
- Adult, Aged, Attitude, Culture, Decision Making, Female, Humans, Intensive Care Units, Male, Middle Aged, Physicians, Probability, Prognosis, Terminal Care, Critical Illness, Proxy, Comprehension, Dissent and Disputes, Qualitative Research
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
