The DOI matches its Crossref record; 49 of the 50 references it cites were found in a registry or an index; none of the 18 sources its claims cite is checked for support yet.
Associations Between End-of-Life Discussions, Patient Mental Health, Medical Care Near Death, and Caregiver Bereavement Adjustment
Open accessAbstract
CONTEXT: Talking about death can be difficult. Without evidence that end-of-life discussions improve patient outcomes, physicians must balance their desire to honor patient autonomy against a concern of inflicting psychological harm. OBJECTIVE: To determine whether end-of-life discussions with physicians are associated with fewer aggressive interventions. DESIGN, SETTING, AND PARTICIPANTS: A US multisite, prospective, longitudinal cohort study of patients with advanced cancer and their informal caregivers (n = 332 dyads), September 2002-February 2008. Patients were followed up from enrollment to death, a median of 4.4 months later. Bereaved caregivers' psychiatric illness and quality of life was assessed a median of 6.5 months later. MAIN OUTCOME MEASURES: Aggressive medical care (eg, ventilation, resuscitation) and hospice in the final week of life. Secondary outcomes included patients' mental health and caregivers' bereavement adjustment. RESULTS: One hundred twenty-three of 332 (37.0%) patients reported having end-of-life discussions before baseline. Such discussions were not associated with higher rates of major depressive disorder (8.3% vs 5.8%; adjusted odds ratio [OR], 1.33; 95% confidence interval [CI], 0.54-3.32), or more worry (mean McGill score, 6.5 vs 7.0; P = .19). After propensity-score weighted adjustment, end-of-life discussions were associated with lower rates of ventilation (1.6% vs 11.0%; adjusted OR, 0.26; 95% CI, 0.08-0.83), resuscitation (0.8% vs 6.7%; adjusted OR, 0.16; 95% CI, 0.03-0.80), ICU admission (4.1% vs 12.4%; adjusted OR, 0.35; 95% CI, 0.14-0.90), and earlier hospice enrollment (65.6% vs 44.5%; adjusted OR, 1.65;95% CI, 1.04-2.63). In adjusted analyses, more aggressive medical care was associated with worse patient quality of life (6.4 vs 4.6; F = 3.61, P = .01) and higher risk of major depressive disorder in bereaved caregivers (adjusted OR, 3.37; 95% CI, 1.12-10.13), whereas longer hospice stays were associated with better patient quality of life (mean score, 5.6 vs 6.9; F = 3.70, P = .01). Better patient quality of life was associated with better caregiver quality of life at follow-up (beta = .20; P = .001). CONCLUSIONS: End-of-life discussions are associated with less aggressive medical care near death and earlier hospice referrals. Aggressive care is associated with worse patient quality of life and worse bereavement adjustment.
Overview
Integrity signals
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Claims the paper makes
36 Own result · 7 Not checked yet · 7 Own method · 4 Own interpretation · 1 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Caregivers of patients with high QoL felt better prepared for the death (β=0.23, p=0.002)”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > RESULTS > Bereavement Outcomes
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Caregiver report accurately reflects the patient's quality of life near death.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patients reporting discussions had lower performance status (59.5 vs. 65.7; p=0.003)”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > RESULTS > Patient characteristics
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“while longer hospice stays were associated with better patient QoL (5.6 vs. 6.9; F=3.70, p=0.01)”
- Also stated in: § Patients’ Quality of Life at EOL · plain
“The inverse was true for hospice care, where patients’ QoL improved the longer they were enrolled, except for patients who received less than one week of services.”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > Abstract > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Caregiver report accurately reflects the patient's quality of life near death.
- Also stated in: § Patients’ Quality of Life at EOL · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Caregivers of patients who received any aggressive care were at higher risk for developing a Major Depressive Disorder (AOR 3.37, 95% CI 1.12-10.13), experiencing regret (β=0.17; p=0.01), and feeling unprepared for the patient’s death (β=−0.30; p<0.001)”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > RESULTS > Bereavement Outcomes
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“improvements in self-rated change in health (AOR 1.17, 95% CI 1.05, 1.29)”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > RESULTS > Bereavement Outcomes
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Caregiver report accurately reflects the patient's quality of life near death.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“123 of 332 (37.0%) patients reported EOL discussions before baseline.”
- Also stated in: § Patient characteristics · plain
“Overall, 123 of 332 (37.0%) patients reported having EOL discussions with their physicians at baseline.”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > Abstract > Results
plainn = 332- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Patient self-report accurately identifies whether an end-of-life discussion occurred.
- Also stated in: § Patient characteristics · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“complete a do-not-resuscitate order (63.0% vs. 28.5%).”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > RESULTS > Mental health, treatment preferences, and advance care planning
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Patient self-report accurately identifies whether an end-of-life discussion occurred.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patients who reported EOL conversations were significantly (p≥0.001) more likely to accept that their illness was terminal (52.9% vs. 28.7%)”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > RESULTS > Mental health, treatment preferences, and advance care planning
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Patient self-report accurately identifies whether an end-of-life discussion occurred.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“higher risk for Major Depressive Disorder in bereaved caregivers (AOR 3.37, 95% CI 1.12-10.13)”
- Also stated in: § Bereavement Outcomes · plain
“Caregivers of patients who received any aggressive care were at higher risk for developing a Major Depressive Disorder (AOR 3.37, 95% CI 1.12-10.13)”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > Abstract > Results
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Also stated in: § Bereavement Outcomes · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As shown in table 2, EOL discussions were not associated with patients feeling “depressed,” “sad,” “terrified,” “worried,” or meeting DSM-IV-criteria for a mental disorder in propensity-weighted analyses.”
- Also stated in: § DISCUSSION · plain
“we found no evidence that they were significantly associated with increased emotional distress or psychiatric disorders.”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > RESULTS > Mental health, treatment preferences, and advance care planning
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: Patient self-report accurately identifies whether an end-of-life discussion occurred.
- Also stated in: § DISCUSSION · plain
- It may state two separate claims as one. 6
- Probably not a substantial claim. 1
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patients who received no aggressive care had a mean QoL score of 6.4, while patients who received 3 or more therapies had a mean QoL score of 4.6 (F=3.61, df=3, p=0.01).”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > RESULTS > Patients’ Quality of Life at EOL
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Caregiver report accurately reflects the patient's quality of life near death.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Patients who did not receive hospice had a mean QoL score of 5.6; those enrolled for one week or less had a QoL score of 5.6; and those enrolled for 2 months or more had QoL scores of 6.9 (F=4.04, df=3, p=0.008).”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > RESULTS > Patients’ Quality of Life at EOL
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Caregiver report accurately reflects the patient's quality of life near death.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Our findings must be interpreted within the context of an observational study that could not randomize terminally ill cancer patients to EOL discussions for ethical and logistical reasons.”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Our study did not include interviews with doctors or audio-taped conversations.”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“it is one of the most robust statistical methods available to correct for potential selection bias and confounding.”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“Physicians also often avoid EOL conversations, communicate euphemistically, are overly optimistic, or delay discussions until patients are close to death, perhaps because their own feelings of failure or loss.4,5,10,13,48,49”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > DISCUSSION
What the sources say
- Not checked yetcites [4]
- Not checked yetcites [5]
- Not checked yetcites [10]
- Not checked yetcites [13]
- Not checked yetcites [48]
- Not checked yetcites [49]
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“EOL discussions may make patients more realistic about the benefits of aggressive therapies, and thereby reduce the likelihood that they receive intensive treatments near death.15,43”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > DISCUSSION
What the sources say
- Not checked yetcites [15]
- Not checked yetcites [43]
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: Patient self-report accurately identifies whether an end-of-life discussion occurred.
The paper relies on this without support.
Patient self-report accurately identifies whether an end-of-life discussion occurred.
“Absent such independent validation, the accuracy of patients’ reported rates of discussions remains unknown”
“we do not know who initiated the conversation, when it happened, or what was said.”
The paper relies on this without support.
Caregiver report accurately reflects the patient's quality of life near death.
“In a post-mortem interview, research staff interviewed the formal/informal caregiver involved in the patients’ care during the final week of life to assess the patient’s QoL near death.”
“source of report for patient QoL”
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?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Misunderstandings about prognosis are common16, 17, 18 and are associated with increased exposure to futile treatments.19, 20, 21, 22”
From 5th ESO-ESMO international consensus guidelines for advanced breast cancer (ABC 5) (2020) · cites this paper as [20]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Delivery of prognostic information and advance care planning are desired by patients, but occur infrequently.”
From Should there be an expanded role for palliative care in end-stage renal disease? (2010) · cites this paper as [10]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Advance care planning has been associated with earlier and increased use of hospice care [12–15], reduced intensive treatment and hospitalizations at the end of life [13, 15–18], and better quality of life in patients with cancer and caregivers [12, 19].”
From Mindfulness to enhance quality of life and support advance care planning: a pilot randomized controlled trial for adults with advanced cancer and their family caregivers. (2024) · cites this paper as [12]
Experimental — accuracy not yet measuredIn the citing paper
“Despite knowledge of poor survival after dialysis initiation, advance care planning occurs infrequently [9,10].”
From Should there be an expanded role for palliative care in end-stage renal disease? (2010) · cites this paper as [10]
In the citing paper
“ESRD patients who have end-of-life discussions with a healthcare provider are more likely to complete advance directives [9,10].”
From Should there be an expanded role for palliative care in end-stage renal disease? (2010) · cites this paper as [10]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > Abstract > Results
“longer hospice stays were associated with better patient QoL (5.6 vs. 6.9; F=3.70, p=0.01)”
§ Associations between end-of-life discussions, patient mental health, medical care near death, and caregiver bereavement adjustment > RESULTS > Patients’ Quality of Life at EOL
“Patients who did not receive hospice had a mean QoL score of 5.6; those enrolled for one week or less had a QoL score of 5.6; and those enrolled for 2 months or more had QoL scores of 6.9 (F=4.04, df=3, p=0.008).”
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Approximately One In Three US Adults Completes Any Type Of Advance Directive For End-Of-Life Care
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“Evidence suggests that less aggressive care is also less costly(31-33) and less burdensome for surviving family members.(3,34) Given the many arguments for less aggressive EOL care, earlier discussions have the potential to change the way EOL care is delivered for patients with advanced cancer and help to assure that…”
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“These associations were over and above established predictors of EoL care, such as race(29,30) and EoL care preferences.(31,32) Additionally, spiritual care was found to be associated with better patient QoL at the EoL.”
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Failure to engage hospitalized elderly patients and their families in advance care planning
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Availability and Integration of Palliative Care at US Cancer Centers
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“When appropriate, clinicians might include chaplains or other trained professionals (eg, liaison psychiatrists(37)) to inquire about religious coping during family meetings while the patient is in an intensive care unit and end-of-life discussions occurring earlier in the disease course.(38) Because aggressive endof-l…”
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Integrating palliative care into the trajectory of cancer care
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Family Perspectives on Aggressive Cancer Care Near the End of Life
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End-of-Life Care Discussions Among Patients With Advanced Cancer: A Cohort Study
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“Patients 1535 620 Sex† Male 952 (62) 368 (59) Female 583 (38) 252 (41) Race† White 1210 (79) 413 (67) Black 170 (11) 121 (20) Asian 83 (5) 37 (6) Other 69 (4) 47 (8) Missing 3 (0.”
BackgroundInfluentialEndpoints in medical communication research, proposing a framework of functions and outcomes
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“Interestingly, a recent study investigating the effectiveness of the provision of an end of life conversation with terminal patients’ turned out to a reduced use of advanced treatment modalities [28].”
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Effect of the Serious Illness Care Program in Outpatient Oncology
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Bending the Cost Curve in Cancer Care
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“This comorbidity is responsible for poor medical outcomes (Katon, 2011; Kisely, Smith, Lawrence, &Maaten, 2005; Wright et al., 2008), significant decrements in quality of life (Fortin et al.”
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“6% of patients in our study recalled prior prognostic disclosures, particularly considering that 37% of our cohort reported previously discussing their EOL care preferences.(46) This difference suggests that discussing one’s hypothetic EOL preferences may be less threatening than discussing the timeframe of one’s deat…”
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“Such discussions at family meetings lead to lower costs and a lighter family burden (Wright et al. 2008, 2010) and improve family satisfaction and bereavement outcomes (Wright et al. 2008; Zhang et al. 2009).”
BackgroundInfluentialPadeletti, L., Arnar, D. O., Boncinelli, L., Brachman, J., Camm, A. J., Daubert, J., Kassam, S., Deliëns, L., Glikson, M., Hayes, D. L., et al. (2010) · EP Europace · doi:10.1093/europace/euq275 · Cited by 382
Culture and Palliative Care: Preferences, Communication, Meaning, and Mutual Decision Making
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Ethics and end-of-life care for adults in the intensive care unit
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Balboni, T. A., Balboni, M. J., Enzinger, A. C., Gallivan, K., Paulk, M. E., Wright, A. A., Steinhauser, K. E., VanderWeele, T. J., & Prigerson, H. G. (2013) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.903 · Cited by 361
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Physician factors associated with discussions about end‐of‐life care
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Communication in palliative care: talking about the end of life, before the end of life
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“Although aggressive medical interventions may be appropriate for, and preferred by, some individuals, patients’ quality of life and relatives’ bereavement adjustment are reported as significantly better when patients receive fewer aggressive medical treatments towards the end-of-life (14).”
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“Outcomes We obtained the secondary outcomes reported herein from EMR review for patients who had died, including (1) proportion of patients with at least 1 documented serious illness conTable 1.”
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Self-citationREMAP: A Framework for Goals of Care Conversations
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Quality of end‐of‐life care in patients with hematologic malignancies: A retrospective cohort study
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Referral criteria for outpatient specialty palliative cancer care: an international consensus
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Factors Important to Patients' Quality of Life at the End of Life
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Mack, J. W., & Smith, T. J. (2012) · Journal of Clinical Oncology · doi:10.1200/jco.2012.42.4564 · Cited by 299
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“At the end of life, the presence of supportive/palliative care might also help patients to avoid unnecessarily harmful therapies that have no chance of meeting their goals of care.(18)”
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Morrison, L. J., Neumar, R. W., Zimmerman, J. L., Link, M. S., Newby, L. K., McMullan, P. W., Hoek, T. L. V., Halverson, C. C., Doering, L. V., Peberdy, M. A., et al. (2013) · Circulation · doi:10.1161/cir.0b013e31828b2770 · Cited by 311
Spirituality, Religiosity, and Spiritual Pain in Advanced Cancer Patients
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Triage of Scarce Critical Care Resources in COVID-19 An Implementation Guide for Regional Allocation
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Palliative and End-of-Life Care in Stroke
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Racial Disparities in the Outcomes of Communication on Medical Care Received Near Death
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Curtis, J. R., Downey, L., Back, A. L., Nielsen, E. L., Paul, S. R., Lahdya, A. Z., Treece, P. D., Armstrong, P., Peck, R., & Engelberg, R. A. (2018) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2018.2317 · Cited by 265
El-Jawahri, A. R., Podgurski, L., Eichler, A. F., Plotkin, S. R., Temel, J. S., Mitchell, S. L., Chang, Y., Barry, M. J., & Volandes, A. E. (2009) · Journal of Clinical Oncology · doi:10.1200/jco.2009.24.7502 · Cited by 257
“Previous work has demonstrated that end-of-life discussions are associated with avoidance of CPR and mechanical ventilation near death and with earlier hospice referrals.(25,26) These findings suggest that when patients have a better understanding of their goals-of-care options and the likely outcomes, they tend to op…”
ResultHealth Care Costs for Patients With Cancer at the End of Life
Chastek, B. J., Harley, C., Kallich, J. D., Newcomer, L. N., Paoli, C. J., & Teitelbaum, A. H. (2012) · Journal of Oncology Practice · doi:10.1200/jop.2011.000469 · Cited by 259
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Machine Learning Approaches to Predict 6-Month Mortality Among Patients With Cancer
Parikh, R. B., Manz, C. R., Chivers, C., Regli, S. H., Braun, J., Draugelis, M. E., Schuchter, L. M., Shulman, L. N., Navathe, A. S., Patel, M. S., et al. (2019) · JAMA Network Open · doi:10.1001/jamanetworkopen.2019.15997 · Cited by 250
“Features Our data set included 3 broad classes of variables (ie, features) that are commonly available in EHRs: (1) demographic variables (eg, age and sex); (2) Elixhauser comorbidities,24 and (3) laboratory and select electrocardiogram data.”
The Influence of Doctor-Patient Communication on Health Outcomes: A Systematic Review
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Tulsky, J. A., Beach, M. C., Butow, P. N., Hickman, S. E., Mack, J. W., Morrison, R. S., Street, R. L., Sudore, R. L., White, D. B., & Pollak, K. I. (2017) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2017.2005 · Cited by 246
“greatest returns, and (3) map out an agenda for communication research that includes the identification of potential stakeholders and funding sources.”
BackgroundAnderson, R., Bloch, S., Armstrong, M., Stone, P. C., & Low, J. (2019) · Palliative Medicine · doi:10.1177/0269216319852007 · Cited by 240
El‐Jawahri, A., Traeger, L., Park, E. R., Greer, J. A., Pirl, W. F., Lennes, I. T., Jackson, V. A., Gallagher, E. R., & Temel, J. S. (2014) · Cancer · doi:10.1002/cncr.28369 · Cited by 240
Sudore, R. L., Boscardin, W. J., Feuz, M. A., McMahan, R. D., Katen, M. T., & Barnes, D. E. (2017) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2017.1607 · Cited by 236
Comfort Care for Patients Dying in the Hospital
Blinderman, C. D., & Billings, J. A. (2015) · New England Journal of Medicine · doi:10.1056/nejmra1411746 · Cited by 244
Sinuff, T., Dodek, P., You, J. J., Barwich, D., Tayler, C., Downar, J., Hartwick, M., Frank, C., Stelfox, H. T., & Heyland, D. K. (2015) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2014.12.007 · Cited by 241
Perceived stigma among individuals with common mental disorders
Alonso, J., Burón, A., Rojas‐Farreras, S., de Graaf, R., Haro, J. M., de Girolamo, G., Bruffaerts, R., Kovess–Masféty, V., Matschinger, H., & Vilagut, G. (2009) · Journal of Affective Disorders · doi:10.1016/j.jad.2009.02.006 · Cited by 235
“Work and role limitation in themonth prior to the interview was assessed by the WHODAS-II (Wright et al., 2008).”
MethodDiscussions of Life Expectancy and Changes in Illness Understanding in Patients With Advanced Cancer
Epstein, A. S., Prigerson, H. G., O'Reilly, E. M., & Maciejewski, P. K. (2016) · Journal of Clinical Oncology · doi:10.1200/jco.2015.63.6696 · Cited by 232
“When you think about this, do you think in terms of (select response)?” Response options were (1) months, (2) years, and (3) do not know.”
BackgroundMethodInfluentialLo, C., Zimmermann, C., Rydall, A., Walsh, A., Jones, J. M., Moore, M. J., Shepherd, F. A., Gagliese, L., & Rodin, G. (2010) · Journal of Clinical Oncology · doi:10.1200/jco.2009.26.9712 · Cited by 228
Oonk, M. H. M., Planchamp, F., Baldwin, P., Mahner, S., Mirza, M. R., Fischerová, D., Creutzberg, C. L., Guillot, E., Garganese, G., Lax, S., et al. (2023) · International Journal of Gynecological Cancer · doi:10.1136/ijgc-2023-004486 · Cited by 235
Family-Centered Advance Care Planning for Teens With Cancer
Lyon, M. E., Jacobs, S., Briggs, L., Cheng, Y. I., & Wang, J. (2013) · JAMA Pediatrics · doi:10.1001/jamapediatrics.2013.943 · Cited by 223
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Forman, D. E., Rich, M. W., Alexander, K. P., Zieman, S., Maurer, M. S., Najjar, S. S., Cleveland, J. C., Krumholz, H. M., & Wenger, N. K. (2011) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.02.014 · Cited by 228
“Open discussion about mortality can help ease feelings of isolation, depression, and even selfblame for treatment failure among patients nearing the end of life (64).”
An introduction to advance care planning in practice
Mullick, A., Martin, J., & Sallnow, L. (2013) · BMJ · doi:10.1136/bmj.f6064 · Cited by 220
Sobański, P., Alt‐Epping, B., Currow, D. C., Goodlin, S. J., Grodzicki, T. K., Hogg, K. J., Janssen, D. J. A., Johnson, M. J., Krajnik, M., Leget, C. J. W., et al. (2019) · Cardiovascular Research · doi:10.1093/cvr/cvz200 · Cited by 214
de Graaf, J., van Lingen, R. A., Simons, S. H. P., Anand, K. J. S., Duivenvoorden, H. J., Weisglas‐Kuperus, N., Roofthooft, D. W. E., Jebbink, L. J. G., Veenstra, R., Tibboel, D., et al. (2011) · Pain · doi:10.1016/j.pain.2011.02.017 · Cited by 214
“Flowchart o literature were combined into a propensity score to correct for baseline imbalance [55].”
MethodTimely Palliative Care: Personalizing the Process of Referral
Hui, D., Heung, Y. J., & Bruera, E. D. (2022) · Cancers · doi:10.3390/cancers14041047 · Cited by 215
Referral Criteria for Outpatient Palliative Cancer Care: A Systematic Review
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The Very Elderly Admitted to ICU
Heyland, D. K., Cook, D., Bagshaw, S. M., Garland, A., Stelfox, H. T., Mehta, S., Dodek, P., Kutsogiannis, J., Burns, K. E. A., Muscedere, J., et al. (2015) · Critical Care Medicine · doi:10.1097/ccm.0000000000001024 · Cited by 179
Advance Care Planning Beyond Advance Directives: Perspectives From Patients and Surrogates
McMahan, R. D., Knight, S. J., Fried, T. R., & Sudore, R. L. (2012) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2012.09.006 · Cited by 205
“Yet, decision making is often stressful for both patients and surrogates and many feel unprepared to make informed choices (3-9).”
BackgroundEngaging Diverse English- and Spanish-Speaking Older Adults in Advance Care Planning
Sudore, R. L., Schillinger, D., Katen, M. T., Shi, Y., Boscardin, W. J., Osua, S., & Barnes, D. E. (2018) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2018.4657 · Cited by 200
Mayland, C. R., Harding, A. J. E., Preston, N., & Payne, S. (2020) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2020.05.012 · Cited by 197
Metadata
- Authors
- Wright, A. A.
- Affiliations
- Dana-Farber Cancer Institute (US)
- Corresponding author
- Wright, Alexi A.
- ORCID
- Wright, Alexi A.
- Venue
- JAMA
- Publisher
- American Medical Association (AMA)
- Published
- 2008-10-08
- Volume
- 300
- Issue
- 14
- Pages
- 1665
- ISSN
- 0002-9955 (ISSN-L)
- 0098-7484
- PMC
- PMC2853806
- OpenAlex
- W2137401089
- Cited by
- 2,788
- References
- 50
- Citations by year
- 2026: 115 · 2025: 132 · 2024: 152 · 2023: 167 · 2022: 186 · 2021: 221 · 2020: 215 · 2019: 225 · 2018: 178 · 2017: 207 · 2016: 179 · 2015: 159 · 2014: 143 · 2013: 136 · 2012: 110
- FWCI
- 84.45
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- JAMA (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (acceptedVersion)
- Funders
- McGill University
- National Institute on Aging (K24AG033640)
- National Institute of Mental Health (MH-63892, R01MH063892)
- National Cancer Institute (R01CA106370, CA106370, CA 92044343, T32CA009172)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Keywords
- end-of-life discussions, advance care planning, mechanical ventilation, cardiopulmonary resuscitation, hospice enrollment, advanced cancer, patient mental health, major depressive disorder, informal caregivers, quality of life, intensive care unit admission, physician-patient communication, patient autonomy
- MeSH terms
- Adaptation, Psychological, Aged, Attitude to Death, Bereavement, Female, Humans, Longitudinal Studies, Male, Mental Health, Middle Aged, Neoplasms, Physician-Patient Relations, Physician's Role, Quality of Life, Resuscitation, Terminal Care, Caregivers, Hospice Care, Terminally Ill, Advance Care Planning
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.
A language model drew the claims from the paper on 2026-09-28, under version 3 of the claim definition (prompt extract-v3).
A second model labelled each claim on 2026-09-28 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
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 ›
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