Evidence map›Paper›PMID 40010059›Full record

ArticlePatient education and counseling2025

Questions older people and caregivers ask about kidney therapies: A computer-assisted analysis.

Rebecca Allen, Alex Nakonechnyi, Sally A Norton, Fahad Saeed

Abstract read
In one paragraph

Article in Patient education and counseling, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Rebecca AllenMount St. Joseph University, Center for IT Engagement (cITe), Cincinnati, OH, United States. Electronic address: rebecca.allen@msj.edu.
Alex NakonechnyiMount St. Joseph University, Center for IT Engagement (cITe), Cincinnati, OH, United States.
Sally A NortonUniversity of Rochester, School of Nursing, Rochester, NY, United States.
Fahad SaeedDivision of Nephrology, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, United States.

Funding

Outcomes of a Palliative Care Intervention to Improve Kidney Therapy-Decision Making for Older People with Advanced CKDR01AG082891 · NIA · UNIVERSITY OF ROCHESTER · PI Fahad Saeed · 2024 to 2026
$2.0M
Pilot Testing of a Communication Intervention to Promote Shared Dialysis Decision Making in Older Patients with Chronic Kidney Disease (DIAL-SDM Trial)K23DK121939 · NIDDK · UNIVERSITY OF ROCHESTER · PI SAEED, FAHAD · 2020 to 2023
$839k
NIA NIH HHS R01 AG082891NIDDK NIH HHS K23 DK121939
6 · The paper itself

Abstract

backgroundOlder adults with advanced chronic kidney disease (CKD) face complex and often overwhelming decisions regarding kidney therapy (KT), yet little is known about the specific information they and their caregivers seek during these discussions. Understanding informational needs is critical for improving shared decision-making.

objectivesTo identify and compare questions asked by patients and caregivers during KT decision-making visits.

methodsA dataset of 36 transcribed kidney therapy (KT) decision-making focused outpatient palliative care encounters-conducted by a single clinician in patient homes and/or a single clinic-was analyzed using computational linguistic techniques supplemented by manual verification. Participants included 25 patients aged ≥ 75 years with an estimated glomerular filtration rate ≤ 25 ml/min/1.73 m², identified by nephrologists as needing KT decision-making support. Caregivers (n = 15) were included when present. All patients received a decision aid and question prompt list. Visits were led by a nephrologist board-certified in palliative care.

resultsAcross 36 visits, 640 questions were recorded, averaging 17.78 per visit. The presence of a caregiver did not significantly affect the number of questions patients asked (10.42 vs. 10.00). Patients were more likely to ask conversational cooperation questions (37 % vs. caregivers' 19 %), while caregivers focused more on dialysis (38 % vs. patients' 25 %). Both groups asked a similar amount of questions about chronic kidney disease (patients 11 %, caregivers 10 %) and conservative kidney management (patients 4 %, caregivers 5 %). End-of-life inquiries were minimal, with patients asking 4 % of questions and caregivers none.

conclusionsPatients and caregivers have different information needs during KT decision-making, highlighting the importance of addressing educational, decisional, and EOL planning gaps. PRACTICE IMPLICATIONS: Targeted educational interventions that address patients' and caregivers' unique preferences and information gaps are essential, including question prompt lists and decision aids with coaching, which AI-driven approaches could further optimize.

Indexed as

CaregiversDecision MakingDecision Making, SharedPatient ParticipationRenal Insufficiency, ChronicAgedAged, 80 and overCommunicationDecision Support TechniquesFemaleHumansMalePalliative CareChronic Kidney DiseaseComputational Linguistic AnalysisEnd-of-Life PlanningKidney Therapy Decision-MakingNephrology Communication

Identifiers

PMID40010059
PMCPMC12020433

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.