1
40
3
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://doi.org/10.1200/jco.2009.24.6397" target="_blank" rel="noreferrer">http://doi.org/10.1200/jco.2009.24.6397</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Paradoxes in advance care planning: the complex relationship of oncology patients, their physicians, and advance medical directives.
Publisher
An entity responsible for making the resource available
Journal Of Clinical Oncology
Date
A point or period of time associated with an event in the lifecycle of the resource
2010
Subject
The topic of the resource
Female; Humans; Male; Young Adult; Palliative Care; Terminal Care; Family; Adult; Interviews as Topic; Aged; Middle Aged; Physicians; Medical Oncology; 80 and over; advance care planning; DNAR; Advance Directives; Physician-Patient Relations; Patient Preference; Neoplasms/px [Psychology]
Creator
An entity primarily responsible for making the resource
Dow LA; Matsuyama RK; Ramakrishnan V; Kuhn L; Lamont EB; Lyckholm L; Smith TJ
Description
An account of the resource
PURPOSE: Many seriously ill patients with cancer do not discuss prognosis or advance directives (ADs), which may lead to inappropriate and/or unwanted aggressive care at the end of life. Ten years ago, patients with cancer said they would not like to discuss ADs with their oncologist but would be willing to discuss them with an admitting physician. We assessed whether this point of view still held., PATIENTS AND METHODS: Semi-structured interviews were conducted with 75 consecutively admitted patients with cancer in the cancer inpatient service., RESULTS: Of those enrolled, 41% (31 of 75) had an AD. Nearly all (87%, 65 of 75) thought it acceptable to discuss ADs with the admitting physician with whom they had no prior relationship, and 95% (62 of 65) thought that discussing AD issues was very or somewhat important. Only 7% (5 of 75) had discussed ADs with their oncologist, and only 23% (16 of 70) would like to discuss ADs with their oncologist. When specifically asked which physician they would choose, 48% (36 of 75) of patients would prefer their oncologist, and 35% (26 of 75) would prefer their primary care physician., CONCLUSION: Fewer than half of seriously ill patients with cancer admitted to an oncology service have an AD. Only 23% (16 of 70) would like to discuss their ADs with their oncologist but nearly all supported a policy of discussing ADs with their admitting physician. However, fully 48% (36 of 75) actually preferred to discuss advance directives with their oncologist if AD discussion was necessary. We must educate patients on why communicating their ADs is beneficial and train primary care physicians, house staff, hospitalists, and oncologists to initiate these difficult discussions.
2010
Identifier
An unambiguous reference to the resource within a given context
<a href="http://doi.org/10.1200/jco.2009.24.6397" target="_blank" rel="noreferrer">10.1200/jco.2009.24.6397</a>
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2010
80 And Over
Adult
Advance Care Planning
Advance Directives
Aged
Backlog
DNAR
Dow LA
Family
Female
Humans
Interviews As Topic
Journal Article
Journal Of Clinical Oncology
Kuhn L
Lamont EB
Lyckholm L
Male
Matsuyama RK
Medical Oncology
Middle Aged
Neoplasms/px [psychology]
Palliative Care
Patient Preference
Physician-patient Relations
Physicians
Ramakrishnan V
Smith TJ
Terminal Care
Young Adult
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12837717" target="_blank" rel="noreferrer">http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=12837717</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Complexities in prognostication in advanced cancer: "to help them live their lives the way they want to"
Publisher
An entity responsible for making the resource available
Jama
Date
A point or period of time associated with an event in the lifecycle of the resource
2003
Subject
The topic of the resource
Female; Physician-Patient Relations; Prognosis; Aged; Patient Participation; Survival Analysis; Antineoplastic Agents; 80 and over; Non-U.S. Gov't; P.H.S.; U.S. Gov't; algorithms; Human; Truth Disclosure; Support; Adenocarcinoma/drug therapy/secondary; Hormonal/therapeutic use; Skin Neoplasms/drug therapy/secondary; Stomach Neoplasms/drug therapy/pathology; Tamoxifen/therapeutic use
Creator
An entity primarily responsible for making the resource
Lamont EB; Christakis NA
Description
An account of the resource
Predicting survival and disclosing the prediction to patients with advanced disease, particularly cancer, is among the most difficult tasks that physicians face. With the de-emphasis of prognosis in favor of diagnosis and therapeutics in the medical literature, physicians may have difficulty finding the survival information they need to make appropriate estimates of survival for patients who develop cancer. Quite separate from the challenge of estimating survival accurately, physicians may also find the process of disclosing the prognosis to their patients difficult. Using the vignette of a real patient with advanced cancer who far outlived her physician's prognostic estimate, we discuss clinical issues related to the science of prognosis in advanced cancer and the art of its disclosure.
2003
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2003
80 And Over
Adenocarcinoma/drug therapy/secondary
Aged
algorithms
Antineoplastic Agents
Backlog
Christakis NA
Female
Hormonal/therapeutic use
Human
JAMA
Journal Article
Lamont EB
Non-U.S. Gov't
P.H.S.
Patient Participation
Physician-patient Relations
Prognosis
Skin Neoplasms/drug therapy/secondary
Stomach Neoplasms/drug therapy/pathology
Support
Survival Analysis
Tamoxifen/therapeutic use
Truth Disclosure
U.S. Gov't
-
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
Citation List Month
Backlog
URL Address
<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10678857" target="_blank" rel="noreferrer">http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&dopt=Citation&list_uids=10678857</a>
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
A name given to the resource
Extent and determinants of error in doctors' prognoses in terminally ill patients: prospective cohort study
Publisher
An entity responsible for making the resource available
Bmj
Date
A point or period of time associated with an event in the lifecycle of the resource
2000
Subject
The topic of the resource
Male; Survival Rate; Cohort Studies; Prognosis; Prospective Studies; Non-U.S. Gov't; Human; Support; Terminally Ill; Clinical Competence/standards; Medical Errors/statistics & numerical data; Terminal Care/standards
Creator
An entity primarily responsible for making the resource
Christakis NA; Lamont EB
Description
An account of the resource
OBJECTIVE: To describe doctors' prognostic accuracy in terminally ill patients and to evaluate the determinants of that accuracy. DESIGN: Prospective cohort study. SETTING: Five outpatient hospice programmes in Chicago. PARTICIPANTS: 343 doctors provided survival estimates for 468 terminally ill patients at the time of hospice referral. MAIN OUTCOME MEASURES: Patients' estimated and actual survival. RESULTS: Median survival was 24 days. Only 20% (92/468) of predictions were accurate (within 33% of actual survival); 63% (295/468) were overoptimistic and 17% (81/468) were overpessimistic. Overall, doctors overestimated survival by a factor of 5.3. Few patient or doctor characteristics were associated with prognostic accuracy. Male patients were 58% less likely to have overpessimistic predictions. Non-oncology medical specialists were 326% more likely than general internists to make overpessimistic predictions. Doctors in the upper quartile of practice experience were the most accurate. As duration of doctor-patient relationship increased and time since last contact decreased, prognostic accuracy decreased. CONCLUSION: Doctors are inaccurate in their prognoses for terminally ill patients and the error is systematically optimistic. The inaccuracy is, in general, not restricted to certain kinds of doctors or patients. These phenomena may be adversely affecting the quality of care given to patients near the end of life.
2000
Rights
Information about rights held in and over the resource
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Type
The nature or genre of the resource
Journal Article
2000
Backlog
Bmj
Christakis NA
Clinical Competence/standards
Cohort Studies
Human
Journal Article
Lamont EB
Male
Medical Errors/statistics & numerical data
Non-U.S. Gov't
Prognosis
Prospective Studies
Support
Survival Rate
Terminal Care/standards
Terminally Ill