Randomized controlled trial of a video decision support tool for cardiopulmonary resuscitation decision making in advanced cancer Journal Article

Authors: Volandes, A. E.; Paasche-Orlow, M. K.; Mitchell, S. L.; El-Jawahri, A.; Davis, A. D.; Barry, M. J.; Hartshorn, K. L.; Jackson, V. A.; Gillick, M. R.; Walker Corkery, E. S.; Chang, Y.; Lopez, L.; Kemeny, M.; Bulone, L.; Mann, E.; Misra, S.; Peachey, M.; Abbo, E. D.; Eichler, A. F.; Epstein, A. S.; Noy, A.; Levin, T. T.; Temel, J. S.
Article Title: Randomized controlled trial of a video decision support tool for cardiopulmonary resuscitation decision making in advanced cancer
Abstract: Purpose: Decision making regarding cardiopulmonary resuscitation (CPR) is challenging. This study examned the effect of a video decision support tool on CPR preferences among patients with advanced cancer. Patients and Methods: We performed a randomized controlled trial of 150 patients with advanced cancer from four oncology centers. Participants in the control arm (n = 80) listened to a verbal narrative describing CPR and the likelihood of successful resuscitation. Participants in the intervention arm (n = 70) istened to the identical narrative and viewed a 3-minute video depicting a patient on a ventilator and CPR being performed on a simulated patient. The primary outcome was participants' preference for or against CPR measured immediately after exposure to either modality. Secondary outcomes were participants' knowledge of CPR (score range of 0 to 4, with higher score indicating more knowledge) and comfort with video Results: The mean age of participants was 62 years (standard deviation, 11 years); 49% were women, 44% were African American or Latino, and 47% had lung or colon cancer. After the verbal narrative, in the control arm, 38 participants (48%) wanted CPR, 41 (51%) wanted no CPR, and one (1%) was uncertain. In contrast, in the intervention arm, 14 participants (20%) wanted CPR, 55 (79%) wanted no CPR, and 1 (1%) was uncertain (unadjusted odds ratio, 3.5; 95% CI, 1.7 to 7.2; P <.001). Mean knowledge scores were higher in the intervention arm than in the control arm (3.3 ± 1.0 v2.6 ± 1.3, respectively; P<.001), and 65 participants (93%) in the intervention arm were comfortable watching the video. Conclusion: Participants with advanced cancer who viewed a video of CPR were less likely to opt for CPR than those who listened to a verbal narrative © 2012 by American Society of Clinical Oncology.
Journal Title: Journal of Clinical Oncology
Volume: 31
Issue: 3
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2013-01-20
Start Page: 380
End Page: 386
Language: English
DOI: 10.1200/jco.2012.43.9570
PROVIDER: scopus
PUBMED: 23233708
PMCID: PMC4090424
Notes: --- - "Export Date: 1 March 2013" - "CODEN: JCOND" - "Source: Scopus"
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MSK Authors
  1. Ariela Noy
    205 Noy
  2. Tomer T Levin
    58 Levin
  3. Andrew Saul Epstein
    68 Epstein