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72/100

✓ Peer-reviewed alzhub usefulness score 72 out of 100. End-of-life care

Topic: Risk, prevention and care in population studies

Plain-language summary

Background/aims Ensuring fidelity to a behavioral intervention implemented in nursing homes requires awareness of the unique considerations of this setting for research. The purpose of this article is to describe the goals of care cluster-randomized trial and the methods used to monitor and promote fidelity to a goals of care decision aid intervention delivered in nursing homes. Methods The cluster randomized trial tested whether a decision aid for goals of care in advanced dementia could improve (1) the quality of communication and decision-making, (2) the quality of palliative care, and (3) the quality of dying for nursing home residents with advanced dementia. In 11 intervention nursing homes, family decision-makers for residents with advanced dementia received a two-component intervention: viewing a video decision aid about goals of care choices and then participating in a structured decision-making discussion with the nursing home care plan team, ideally within 3 months after the decision aid was viewed. Following guidelines from the National Institutes of Health Behavior Change Consortium, fidelity was assessed in study design, in nursing home staff training for intervention implementation, and in monitoring and receipt of the intervention. We also monitored the content and timing of goals of care discussions. Results Investigators enrolled 151 family decision-maker/resident dyads in intervention sites; of those, 136 (90%) received both components of the intervention, and 92%-99% of discussions addressed each of four recommended content areas-health status, goals of care, choice of a goal, and treatment planning. A total of 94 (69%) of the discussions between family decision-makers and the nursing home care team were completed within 3 months. Conclusion The methods we used for intervention fidelity allowed nursing home staff to implement a goals of care decision aid intervention for advanced dementia. Key supports for implementation included design features that aligned with nursing home practice, efficient staff training, and a structured guide for goals of care discussions between family decision-makers and staff. These approaches may be used to promote fidelity to behavioral interventions in future clinical trials.

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

APA 7th

Hanson, L. C., Song, M. K., Zimmerman, S., Gilliam, R., Rosemond, C., Chisholm, L., et al. (2016). Fidelity to a behavioral intervention to improve goals of care decisions for nursing home residents with advanced dementia. Clinical trials (London, England). https://doi.org/10.1177/1740774516650863

Vancouver

Hanson LC, Song MK, Zimmerman S, Gilliam R, Rosemond C, Chisholm L, et al. Fidelity to a behavioral intervention to improve goals of care decisions for nursing home residents with advanced dementia. Clinical trials (London, England). 2016. doi:10.1177/1740774516650863. PMID: 27271683.

BibTeX

@article{hanson2016-27271683,
  author  = {Hanson, L. C. and Song, M. K. and Zimmerman, S. and Gilliam, R. and Rosemond, C. and Chisholm, L. and Lin, F. C.},
  title   = {{Fidelity to a behavioral intervention to improve goals of care decisions for nursing home residents with advanced dementia}},
  journal = {Clinical trials (London, England)},
  year    = {2016},
  doi     = {10.1177/1740774516650863},
  pmid    = {27271683},
  url     = {https://doi.org/10.1177/1740774516650863}
}

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.

How to read this study

Design: this is a trial. Participants are assigned to a treatment or a comparison, so the key questions are who was enrolled, whether the comparison group got a placebo or nothing, how long people were followed, and whether the result is on a measure that matters to patients or on a biomarker. Open-label and small trials can overstate benefit.
Size: the record lists 151 participants. Ask whether that is enough for the question, and who they were.
Effect: the record gives no effect size, so the summary above cannot say how large any difference was.

What the evidence grade means here

This page is graded high. alzhub.org assigns the grade automatically from keywords in the abstract, not from reading the paper. High means the abstract mentions a randomized design, a meta-analysis or a systematic review. It can add at most 5 of the 100 points in the study score, and it is a label about design, not a verdict on whether the findings are true.

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Key findings

Results Investigators enrolled 151 family decision-maker/resident dyads in intervention sites; of those, 136 (90%) received both components of the intervention, and 92%-99% of discussions addressed each of four recommended content areas-health status, goals of care, choice of a goal, and treatment planning.

Study details

Study designrandomized controlled trial
Participants151
Evidence strengthHigh

How this study scored 72/100

Published in a peer-reviewed journal, and it is a randomized controlled trial. Scored zero for effect reported because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multicenter collaboration, so those were left out: it earned 42 of the 58 points we could judge it on, which is 72 out of 100.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Clinical trials (London, England))
Journal's citation record	— / 4	No journal record from OpenAlex — left out of this score
Study design	11 / 12	A randomized controlled trial
Strength of evidence	5 / 5	Rated “high” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	2016 — within 20 year(s) of the newest study here
Sample size	2 / 4	151 participants
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomized / blinded	1 / 2	Randomized (as stated in the record)
Times cited	— / 7	No citation count (not found in OpenAlex) — left out of this score
Citations per year	— / 5	No citation count or no year — left out of this score
Impact for its field and year	— / 6	No field-weighted citation impact (OpenAlex has none yet) — left out of this score
Cited by studies here	— / 6	Not yet checked against this library's citation graph — left out of this score
Still being cited	— / 4	No yearly citation counts — left out of this score
Senior author's track record	— / 4	Senior author's record not available — left out of this score
Institution's track record	— / 3	No institution listed in OpenAlex — left out of this score
Multicenter collaboration	— / 3	Institutions not listed — left out of this score
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 27271683)
Free to read	0 / 2	Behind a paywall — scores zero
Points	42 / 58	Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 42 of the 58 points we could judge it on is 72 out of 100.
Total	72 / 100	—

What each of these 20 components measures, and what this score is not →

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