ICU sedation, delirium & recovery
Prevalence and predictors of shared decision-making in goals-of-care clinician-family meetings for critically ill neurologic patients: a multi-center mixed-methods study
Authors' conclusion
Fewer than 1 in 10 goals-of-care clinician-family meetings for critically ill neurological patients contained all shared decision-making elements.
Study context
- Population
- Surrogates and clinicians in goals-of-care clinician-family meetings for critically ill neurological patients, 7 US hospitals
- Participants
- 72 meetings
- Outcome
- Extent of shared decision-making (validated 10-element instrument score)
Methodological detailsmulticentre, audio-recorded meetings, mixed-effects regression
- Multicentre
- Audio-recorded meetings
- Mixed-effects regression
Main finding
As reported in the abstract
Shared decision-making score
- Meetings containing all 10 elements
- 6%
- Discussing uncertainty
- 89%
- Assessing family understanding
- 86%
- Assessing the need for input from others
- 36%
- Eliciting the context of the decision
- 33%
Further findings
Clinician-family prognostic discordance (≥ 20% absolute difference)
- Discordance for hospital survival
- 60%
- Discordance for 6-month independent function
- 45%
Predictors of greater shared decision-making (mixed-effects regression)
- Univariate: younger clinician age, fewer years in practice, specialty, higher prognostic discordance for hospital survival associated with greater shared decision-making
- After adjustment, only higher prognostic discordance for hospital survival independently associated (p = 0.029)
Original publication
Prevalence and predictors of shared decision-making in goals-of-care clinician-family meetings for critically ill neurologic patients: a multi-center mixed-methods study. Crit Care. Published 21 October 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →