Randomized trial of a hospice video decision aid for patients with advanced cancer and their caregivers.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 11513-11513
Author(s):  
Areej El-Jawahri ◽  
Olivia Vanbenschoten ◽  
Alyssa L. Fenech ◽  
Amanda L. Jankowski ◽  
Netana Markovitz ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Advanced Cancer ◽  
Decision Aid ◽  
Hospice Care ◽  
Decision Support Tool ◽  
Verbal Description ◽  
Post Intervention ◽  
Support Tool ◽  
Video Group ◽  
The Impact

11513 Background: Although hospice provides high-quality end-of-life (EOL) care for patients with advanced cancer and their family caregivers, the service remains underutilized in part due to lack of adequate information provided to patients and families about hospice care. Methods: We conducted a single-site randomized clinical trial of a hospice video decision aid versus a verbal description in 150 hospitalized patients with advanced cancer and their caregivers. Patients without an available caregiver were still eligible to participate. Intervention participants (75 patients; 18 caregivers) received a verbal description about hospice plus a six-minute video depicting hospice care. Control participants (75 patients; 26 caregivers) received only the verbal description. The primary endpoint was patient preference for hospice care immediately after the intervention, adjusting for baseline preferences. Secondary outcomes included patient and caregiver knowledge and perceptions of hospice (Hospice Perception and Knowledge Questionnaire). Results: Between 2/2017 and 1/2019, we enrolled 55.7% (150/269) of potentially eligible patients and 44 caregivers. Post-intervention, patients assigned to the video group were more likely to prefer hospice care at the EOL (86.7% vs. 82.7%, OR = 2.85, P = 0.08), but this was not statistically significant. Patients in the video group reported greater knowledge about hospice (B = 0.50, P = 0.024) and were less likely to endorse that hospice care is only about death (6.7% vs. 21.6%, OR = 0.28, P = 0.035). Post-intervention, caregivers assigned to the video were more likely to prefer hospice care for their loved ones (94.4% vs. 65.4%, P = 0.031), reported greater knowledge about hospice (B = 1.94, P < 0.001), and were less likely to endorse that hospice care is only about death (0.0% vs. 23.1%, P = 0.066). Conclusions: Patients with advanced cancer and their caregivers who viewed a hospice video decision support tool were more informed about hospice care and reported more favorable perceptions of hospice. Future work should examine the impact of the video on hospice utilization and length-of-stay among patients with advanced cancer. Clinical trial information: NCT03040102.

Randomized trial of a hospice video decision aid for patients with advanced cancer and their caregivers.

2019 ◽  
Vol 37 (31_suppl) ◽  
pp. 42-42
Author(s):  
Areej El-Jawahri ◽  
Olivia Vanbenschoten ◽  
Sunil Mahesh Bhatt ◽  
Alyssa L. Fenech ◽  
Netana Markovitz ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Advanced Cancer ◽  
End Of Life Care ◽  
Decision Aid ◽  
Hospice Care ◽  
Verbal Description ◽  
Post Intervention ◽  
Included Patient ◽  
Video Group ◽  
Clinical Trial Information

42 Background: Although hospice provides high-quality end-of-life care for patients with advanced cancer, the service remains underutilized in part due to lack of adequate information provided to patients and families about hospice care. Methods: We conducted a single-site randomized clinical trial of a hospice video decision aid versus a verbal description in 150 hospitalized patients with advanced cancer and their caregivers. Patients without an available caregiver were eligible to participate. Intervention participants (75 patients; 18 caregivers) received a verbal description about hospice plus a six-minute video depicting hospice care. Control participants (75 patients; 26 caregivers) received only the verbal description. The primary endpoint was patient preference for hospice care immediately after the intervention, adjusting for baseline preferences. Secondary outcomes included patient and caregiver knowledge and perceptions of hospice, and hospice utilization. Results: Between 2/2017 and 1/2019, we enrolled 55.7% (150/269) of potentially eligible patients and 44 caregivers. Post-intervention, patients assigned to the video group were more likely to prefer hospice care (86.7% vs. 82.7%, OR = 2.85, P = 0.08), but this was not statistically significant. Patients in the video group reported greater knowledge about hospice (B = 0.50, P = 0.024) and were less likely to endorse that hospice care is only about death (6.7% vs. 21.6%, OR = 0.28, P = 0.035). Among patients who died (n = 116), those assigned to the intervention were more likely to utilize hospice (85.2% vs. 63.6%, P = 0.01) and had a longer hospice length-of-stay (LOS) (median 12 vs. 3 days, P < 0.001). Post-intervention, caregivers assigned to the video were more likely to prefer hospice care for their loved ones (94.4% vs. 65.4%, P = 0.031), reported greater knowledge about hospice (B = 1.94, P < 0.001), and were less likely to endorse that hospice care is only about death (0.0% vs. 23.1%, P = 0.066). Conclusions: Patients with advanced cancer and their caregivers who viewed a hospice video decision aid were more informed about hospice, reported more favorable perceptions of hospice, and were more likely to utilize hospice and have a longer hospice LOS. Clinical trial information: NCT03040102.

A video decision support tool for CPR in advanced cancer: A randomized controlled trial.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9004-9004
Author(s):  
Angelo E. Volandes ◽  
Michael Paasche-Orlow ◽  
Areej El-Jawahri ◽  
Susan L. Mitchell ◽  
Margaret Kemeny ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Decision Support ◽  
Advanced Cancer ◽  
Controlled Trial ◽  
Knowledge Score ◽  
The United States ◽  
Verbal Description ◽  
Support Tool ◽  
Randomized Controlled ◽  
Video Group

9004 Background: End-of-life decision-making is important to patients, including whether or not to attempt cardiopulmonary resuscitation (CPR). Doctors often rely solely on verbal descriptions to communicate information regarding CPR. Video decision support tools have the potential to improve patients’ understanding of CPR by providing visual images of what this intervention entails. The objective of this study was to examine the effect of a CPR video among patients with advanced cancer on their preferences and knowledge of CPR. Methods: A randomized controlled trial of 150 subjects with diverse advanced cancers (< 1-year prognosis) recruited from 4 cancer centers in the United States. Subjects were randomized to either a verbal narrative describing CPR, or to a video with verbal narrative. The video depicts CPR and reviews the success rate in advanced cancer. Study endpoints were subjects’ CPR preferences, knowledge of CPR (knowledge scores ranged from 0-4, higher score indicating more knowledge), and perceived value of the video. Chi-square tests were used to compare the distributions of categorical outcomes and two-sample t-tests were used to compare the means between the two groups. Results: A total of 150 subjects were randomized to a verbal narrative (n=80) or video with verbal narrative (n=70). Mean age was 62, 49% were women, 47% White, 34% Black, and 47% had lung or colon cancer. Among subjects receiving the verbal narrative, 38 (47.5%) preferred to have CPR attempted; 41 (51.2%) chose not to have CPR; and 1 (1.3%) was uncertain. In the video group, 14 (20%) preferred to have CPR attempted; 55 (78.6%) chose not to have CPR; and 1 (1.4%) was uncertain (P<0.001). The mean knowledge score was higher in the video group than in the verbal group (3.3 vs. 2.6 respectively; P<0.001). Of the subjects who viewed the video, 94.1% stated they were comfortable watching the video, 97.1% found the video helpful, and 100% would recommend the video. Conclusions: Compared to subjects who only heard a verbal description, subjects with advanced cancer who viewed a CPR video were more likely to prefer not having CPR, and were more knowledgeable about CPR. The majority of subjects found the video helpful, comfortable to view, and would recommend it to others.

User-testing of a decision-support tool for parents facing threatened periviable delivery: The Periviable GOALS decision aid

2020 ◽  
Author(s):  
Brownsyne Tucker Edmonds ◽  
Shelley M Hoffman ◽  
Tatiana Laitano ◽  
Kimberly Coleman-Phox ◽  
Esperanza Castillo ◽  
...  
Keyword(s):  
Decision Support ◽  
Decision Aid ◽  
Decision Support Tool ◽  
User Testing ◽  
Support Tool

Analysis of the Impact of Personalized Nursing Service and Hospice Care on the Quality of Life of Elderly Cancer Patients

2021 ◽  
Vol 7 (4) ◽  
pp. 469-473
Author(s):  
Ting Fang ◽  
Nian Wang ◽  
Meng Chen ◽  
Hongmei Ma
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Advanced Cancer ◽  
Hospice Care ◽  
Pain Treatment ◽  
Control Group ◽  
Study Group ◽  
The Difference ◽  
The Impact

Objective Explore the impact of personalized nursing services and hospice care on the quality of life of elderly patients with advanced cancer. Method We selected 80 elderly cancer patients admitted to our hospital from September 2020 to May 2021, and divided these patients into a study group and a control group using a random number table method. The patients in the control group used conventional nursing methods to treat and care for the patients, and the patients in the study group used hospice care measures and combined personalized nursing measures. The quality of life and pain treatment effects of the two groups of patients before and after treatment were compared. Result Before treatment, the quality-of-life scores of the two groups of patients were low, and there was no statistical difference (P>0.05); After treatment, the quality of life of the two groups of patients improved, but compared with the control group, the improvement was more obvious in the study group, and the difference was statistically significant (P<0.05). In terms of pain treatment effect, the total effective rate of pain treatment in the study group was 87.5%, which was significantly better than the 62.5% in the control group. The difference was statistically significant (P<0.05). Conclusion Personalized nursing services and hospice care are conducive to improving the survival and treatment of elderly patients with advanced cancer, and can be used as a clinical application program for the care of advanced cancer patients.

scholarly journals Preliminary groundwater modelling by considering the interaction with superficial water: Aosta plain case (northern Italy)

2013 ◽  
Author(s):  
Tullia Bonomi ◽  
Letizia Fumagalli ◽  
Valeria Benastini ◽  
Marco Rotiroti ◽  
Pietro Capodaglio ◽  
...  
Keyword(s):  
Water Supply ◽  
Three Dimensional ◽  
Decision Support Tool ◽  
Kriging Interpolation ◽  
Public Water Supply ◽  
Scientific Cooperation ◽  
Public Authorities ◽  
Support Tool ◽  
Hydrogeological Characteristics ◽  
The Impact

The study is developed through scientific cooperation between the University of Milano-Bicocca and the Regional Agency for Environmental Protection (ARPA) of the Valle d’Aosta Region. Its aim is to produce a decision-support tool to help the Public Administration’manage groundwater and public water supply. The study area is the plain of Aosta, between the cities of Aymavilles and Brissogne; in this area groundwater represents the main source of public water supply. The valley is oriented east-west, along the Baltea for a length of 13.1 km and a width of 4.6 km. The textural and hydrogeological properties of the deposits are strictly connected to glacial deposition and to the subsequent sedimentary processes which took place in glacial, lacustrine and fluvial systems. The study is based on available well information in the Aosta plain - including water wells (133) and piezometers (121) - which have been coded and stored in the well database TANGRAM,. The database facilitates interpretation of the well data, and it allows three-dimensional mapping of subsurface hydrogeological characteristics through database codification and ordinary kriging interpolation. The study is designed to achieve two objectives. The first is to provide the Aosta Public Authorities with a well database in order to simplify groundwater management. The second is to provide Public Authorities with a groundwater flow model of the local aquifer. The model integrates surface and subsurface flows in order to fully account for all important stresses, both natural and anthropogenic, on the groundwater system. It provides a tool for testing hypotheses (such as the impact of new wells) and thereby allows science-based management of the aquifer resource.

scholarly journals Decision Support Tool for Offshore Wind Farm Vessel Routing under Uncertainty

Energies ◽  
2018 ◽  
Vol 11 (9) ◽  
pp. 2190 ◽  
Author(s):  
Rafael Dawid ◽  
David McMillan ◽  
Matthew Revie
Keyword(s):  
Wind Farm ◽  
Real Life ◽  
Synthetic Data ◽  
Optimal Solution ◽  
Decision Support Tool ◽  
Offshore Wind ◽  
Offshore Wind Farm ◽  
Support Tool ◽  
Trade Offs ◽  
The Impact

This paper for the first time captures the impact of uncertain maintenance action times on vessel routing for realistic offshore wind farm problems. A novel methodology is presented to incorporate uncertainties, e.g., on the expected maintenance duration, into the decision-making process. Users specify the extent to which these unknown elements impact the suggested vessel routing strategy. If uncertainties are present, the tool outputs multiple vessel routing policies with varying likelihoods of success. To demonstrate the tool’s capabilities, two case studies were presented. Firstly, simulations based on synthetic data illustrate that in a scenario with uncertainties, the cost-optimal solution is not necessarily the best choice for operators. Including uncertainties when calculating the vessel routing policy led to a 14% increase in the number of wind turbines maintained at the end of the day. Secondly, the tool was applied to a real-life scenario based on an offshore wind farm in collaboration with a United Kingdom (UK) operator. The results showed that the assignment of vessels to turbines generated by the tool matched the policy chosen by wind farm operators. By producing a range of policies for consideration, this tool provided operators with a structured and transparent method to assess trade-offs and justify decisions.

Using a decision support tool to screen for pro-poor policies: Application of Extrapolate to smallholder dairy systems in East Africa

2005 ◽  
Vol 2005 ◽  
pp. 28-28
Author(s):  
P. K. Thornton ◽  
P. J. Thorne ◽  
C. Quiros ◽  
D. Sheikh ◽  
R. L. Kruska ◽  
...  
Keyword(s):  
Decision Support ◽  
Poverty Reduction ◽  
Intervention Mapping ◽  
Decision Support Tool ◽  
Target Groups ◽  
Support Tool ◽  
Policy Alternatives ◽  
Ex Ante ◽  
Policy Measures ◽  
The Impact

Extrapolate (EX-ante Tool for RAnking POLicy AlTErnatives) is a decision support tool to assess the impact of policy measures on different target groups. It is designed to serve as a “filter” that, given the broad characteristics of the population, allows the user to sift through different policy measures to assess ex ante the broad potential impacts of these before deciding to look at particular policy options in more detail. Extrapolate models, in a very simple way, the impact of changes on constraints facing potential beneficiary groups, and how these may affect outcomes and their livelihood status. Extrapolate now makes use of mapping facilities from another decision-support tool, PRIMAS (Poverty Reduction Intervention Mapping in Agricultural Systems), that allows the user to match characteristics of particular technological options and constraints with the spatial characteristics of particular target groups in the landscape.

The Competition Between ISPs in Presence of the Net Neutrality

2017 ◽  
Vol 6 (3) ◽  
pp. 166
Author(s):  
Mohamed El Amrani ◽  
Hamid Garmani ◽  
Mohamed Baslam ◽  
Rachid El Ayachi
Keyword(s):  
Quality Of Service ◽  
Service Providers ◽  
Decision Support Tool ◽  
Neutral Network ◽  
Net Neutrality ◽  
Internet Service ◽  
Support Tool ◽  
Content Provider ◽  
The Impact

<p>In this work, we present an economic model of computer networks that describes the in-teraction between Internet Service Providers (ISP ), customers and content provider. The competition between ISP s may be translated by the prices they require and the qualities of service (QoS) they offer. The customer demand for service from an ISP does not only de-pend on the price and quality of service (QoS) of the ISP , but it is influenced by all those offered by its competitors. This behavior has been extensively analyzed using game the-ory as a decision support tool. We interpret a non-neutral network when a content provider privileges ISP s by offering them more bandwidth to ensure proper QoS to support ap-plications that require more data transport capacity (voice over internet protocol (V OIP ) the live video streaming, online gaming). In addition, our work focuses on the price game analysis and QoS between ISP s in two cases: neutral network and non-neutral network. After showing the existence and uniqueness of equilibrium in terms of quality of service, we analyzed the impact of net neutrality on competition between ISP s. We also validated our theoretical study with numerical results, which show that the game has an equilibrium point which depends on all the parameters of the system.</p>

scholarly journals Clinical implementation of pharmacogenomics via a health system-wide research biobank: the University of Colorado experience

2020 ◽  
Vol 21 (6) ◽  
pp. 375-386 ◽  
Author(s):  
Christina L Aquilante ◽  
David P Kao ◽  
Katy E Trinkley ◽  
Chen-Tan Lin ◽  
Kristy R Crooks ◽  
...  
Keyword(s):  
Decision Support ◽  
Health System ◽  
Clinical Decision Support ◽  
Decision Support Tool ◽  
Clinical Decision ◽  
Clinical Implementation ◽  
Support Tool ◽  
University Of Colorado ◽  
The University ◽  
The Impact

In recent years, the genomics community has witnessed the growth of large research biobanks, which collect DNA samples for research purposes. Depending on how and where the samples are genotyped, biobanks also offer the potential opportunity to return actionable genomic results to the clinical setting. We developed a preemptive clinical pharmacogenomic implementation initiative via a health system-wide research biobank at the University of Colorado. Here, we describe how preemptive return of clinical pharmacogenomic results via a research biobank is feasible, particularly when coupled with strong institutional support to maximize the impact and efficiency of biobank resources, a multidisciplinary implementation team, automated clinical decision support tools, and proactive strategies to engage stakeholders early in the clinical decision support tool development process.

Sign in / Sign up

Export Citation Format

Share Document