Table 8:
Effect of Patient Care Planning Discussions on Concordance Between Patient's Wishes and Care Received
| Author, Year | Study Design | Tool Used? | Results Intervention | Results Control | Odds Ratio (95% CI) |
|---|---|---|---|---|---|
|
Single-Provider Discussion vs. Usual Care or No Discussion GRADE for highest-quality evidence: High GRADE for all evidence: Moderate | |||||
| Highest-quality evidence | |||||
| Kirchhoff et al, 2012; (40) Kirchhoff et al, 2010 (41) | Large RCT | Yes | Concordant: 46/62 (74.2%) | Concordant: 30/48 (62.5%) | 1.73 (0.76, 3.90) |
| Lower-quality evidence | |||||
| Mack et al, 2010 (59)a | Obs-cont | No | Concordant: 87/113 (77.0%) | Concordant: 137/219 (62.6%) | 2.00 (1.19, 3.36)b |
| Morrison et al, 2005 (62) | Obs-cont | No | Concordant: 47/49 (95.9%) | Concordant: 79/96 (82.3%) | 5.06 (1.12, 22.87)b |
| Pooled estimate (2 obs-cont studies, FE), I2 = 24% | 2.28 (1.41, 3.70)b | ||||
| Lindner et al, 2007 (66) | Obs-hist | Yes | Concordant: 39/40 (97.5%) | Concordant: 38/44 (86.4%) | 6.16 (0.71, 53.59) |
Abbreviations: CI, confidence interval; FE, fixed effects; GRADE, Grading of Recommendations Assessment, Development, and Evaluation; Obs-cont, observational study with contemporaneous controls; Obs-hist, observational study with historical controls; RCT, randomized controlled trial.
a
Raw numbers were not provided in the article and were therefore estimated using the odds ratio and algebraic formulas.
b
Statistically significant at P ≤ 0.05.