Trial reportJournal of pain and symptom management2025
Impact of Prognostic Notifications on Inpatient Advance Care Planning: A Cluster Randomized Trial.
Trial report in Journal of pain and symptom management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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.
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.
Who cites it
3 citing papers in PubMed.
- Review
- Core Elements of Goals of Care Initiatives Across Eight Health Systems.Journal of pain and symptom management · 2026Article
- From inferring preferences to enabling choice: potentials of digital tools to improve substitute decision-making.Frontiers in digital health · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors.
Funding
Abstract
backgroundA poor prognosis is an important trigger for advance care planning (ACP) conversations, but clinicians often overestimate prognosis.
objectiveTo determine whether ACP note documentation increases by notifying inpatient physicians that a patient is at high risk of mortality.
methodsA pragmatic cluster randomized trial at an academic medical center from September 2021 to December 2022 randomized attending physicians on the inpatient medicine team. An email and page notification was sent to physicians randomized to intervention group for admitted patients at high risk of 30-day and 6-month death based on a machine learning model. The notification recommended to have and document an ACP conversation in the electronic health record (EHR). The primary outcome was documentation of an ACP conversation during hospital admission by the randomized physician. The secondary outcome was ACP note documented by any clinician during the hospital admission. Healthcare utilization outcomes included length of stay and discharge to hospice.
resultsSeventy randomized physicians (35 in each group) cared for 314 unique patients (138 control and 176 intervention) at high risk of mortality. Patients of physicians randomized to the intervention group were more likely to have a documented ACP conversation by the randomized physician compared to the control group (34.7% vs. 19.6%; OR 2.04; 95% CI 1.16-3.59). There was no significant change in ACP documentation by any clinician (52.8% intervention vs. 42.8% control group, OR 1.31; 95% CI 0.81-2.13).
conclusionsMachine learning mortality model notifications can motivate physicians to document ACP conversations during a hospitalization.
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Registered trials
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.