Objective: Clinicians caring for patients with intracerebral hemorrhage must often discuss prognosis and goals of care with their patients’ surrogate decision makers, and may make numeric estimates of likelihood of survival and functional independence, informed by validated prediction models. Surrogates’ prognostic estimates are often discordant with physicians’, suggesting that physicians’ numeric statements may not be accurately interpreted. We sought to assess the relationship between numeracy and interpretation of prognostic estimates in intracerebral hemorrhage among surrogate decision makers. We also assessed surrogates’ application of prognostic estimates to decisions regarding goals of care. Design: Single-center, survey-based, cross-sectional study. Setting: Twenty-two–bed neurologic ICU at an urban, academic hospital. Subjects: Surrogate decision makers for patients admitted to the neurologic ICU. Interventions: Participants completed a survey containing five clinical vignettes describing patients with nontraumatic intracerebral hemorrhage. For each patient, numerical estimates of survival and functional independence were explicitly provided, based on the validated outcome risk stratification scale (intracerebral hemorrhage score) and the Prediction of Functional Outcome in Patients with Primary Intracerebral Hemorrhage score. Measurements and Main Results: Participants were asked to make their own prognostic estimates, as well as to describe their preferred goals of care for each hypothetical patient. Respondent demographics were collected, and numeracy was assessed using a modified Lipkus 11-item scale. Poor numeracy was common (42 of 96 total subjects) in this relatively highly educated population. Most prognostic estimates (55%) made by surrogates were discordant with the provided estimates. High numeracy correlated with better concordance (odds ratio, 23.9 [5.57–97.64]; p
from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2BLwLsN
Εγγραφή σε:
Σχόλια ανάρτησης (Atom)
Δημοφιλείς αναρτήσεις
-
Reuters Health News from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2rI2pFX
-
The new system cuts out the practice of “over triaging calls” and uses an algorithm to suggest to dispatchers what resources are needed fr...
-
Noninvasive ventilation (NIV) is the first-line treatment of adult patients with exacerbations of cystic fibrosis (CF). High-flow nasal oxyg...
-
The new system is meant to allow people who are hard of hearing, speech-impaired or unable to talk safely on the phone to connect with emerg...
-
Objective: It was hypothesized that adding dedicated afternoon rounds for patients’ families to supplement standard family support would imp...
-
International Journal of Environmental Research... Latest Results for Sleep and BreathingIntermitt... Evolutionary Biology News -- S...
-
The American Journal of Emergency Medicine from Emergency Medicine via xlomafota13 on Inoreader http://ift.tt/2iKBYYz
-
Reward and avoidance learning in the context of aversive environments and possible implications for depressive symptoms Abstract Background ...
Δεν υπάρχουν σχόλια:
Δημοσίευση σχολίου