David Casarett

..To determine whether patient preferences are a barrier to hospice enrollment...

..To evaluate the FATE (Family Assessment of Treatment at End of Life) Survey for use as a nationwide quality measure in the VA health care system...

..Therefore, the goal of this study was to compare families' perceptions of end-of-life care among patients who died in VA and non-VA facilities...

..To determine whether inpatient palliative consultation services improve outcomes of care...

..The specific goal of this study was to determine whether these news media communicate differently about cure-directed cancer treatment and end-of-life alternatives...

..In addition, by using patient-identified goals and service needs, the authors recommend a method for making a hospice referral after disclosure of poor prognosis...

..To evaluate the effect of nonresponse bias on reports of the quality of end-of-life care that older adults receive...

..VA efforts to evaluate end-of-life care for veterans should not only measure common aspects of care (e.g., pain management), but also examine performance in areas that are more specific to the veteran population...

..Early experience with FATE suggests that it will be a helpful tool to characterize end-of-life cancer care and to identify targets for quality improvement...

..This Issue Brief summarizes a series of studies that shed light on the decision making process about hospice, and describes a simple, effective way to improve referrals to hospice among nursing home residents...

..Further research is needed to understand patients' needs and beliefs regarding SPCS, and how to integrate SPCS into conventional treatments to improve cancer care...

..The authors used hypothetical Alzheimer's disease studies that included either a blood draw or a blood draw and lumbar puncture to explore older persons' attitudes on this question...

..Because the Family Evaluation of Treatment at End of Life (FATE) survey was too long for routine use in the Veterans Administration (VA) health care system to measure quality of care, a shorter instrument was developed...

..Hospice care may improve the quality of end-of-life care for nursing home residents, but hospice is underutilized by this population, at least in part because physicians are not aware of their patients' preferences...

..The goal of this study was to define families' priorities for various aspects of end-of-life care, and to determine whether scores that reflect these priorities alter facilities' quality rankings...

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..Beyond mild-stage disease, the clinician can largely expect that the caregiver is making the final decisions. These results illustrate how and when caregivers can expect changes in their decision making role...

..It is likely that whatever factors are responsible for lower rates of hospice utilization among African Americans also lead to lower rates of return to hospice after discharge, but this is not known...

..Growing attention to end-of-life care has led to intensive efforts to provide better palliative care. However, it is not known whether palliative care is best provided by consultative teams or in dedicated units...

..Although so-called open-access hospice programs and bridge programs are beginning to offer these services to patients who are still receiving treatment, it is not known whether they best meet patients' needs...

..To determine whether families of patients who enroll in hospice near the end of life believe that they receive less benefit from hospice services than families of patients who enroll earlier...

..To define patients' and families' priorities for information about hospice...

..Therefore, the objective of this study was to determine whether the use of metaphors and analogies in difficult conversations is associated with better patient ratings of their physicians' communication skills...

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..In discussing hospice with AD caregivers, clinicians may want to emphasize selected features of hospice that are particularly important to caregivers...

..Paying patients to participate in clinical trials is ethically controversial. However, there has been no empirical documentation regarding whether payment represents an undue or unjust inducement...

..Cash payments are often used to compensate subjects who participate in research. However, ethicists have argued that these payments might constitute an undue inducement...

..However, further study is needed to evaluate this process in other populations, as well as to determine whether screening questions introduce selection bias in the recruitment process...

..To examine the relationship between worsening physical function and depression and preferences for life-sustaining treatment...

..74-0.84). These results suggest that the STAR offers a unique instrument to measure the work environment hospices provide to their staff...

..Cancer receives a great deal of news media attention. Although approximately half of all US patients with cancer die of their illness or of related complications, it is unknown whether reports in the news media reflect this reality...

..To determine how soap operas portray, and possibly misrepresent, the likelihood of recovery for patients in coma...

..Although the likelihood of distress is low overall, investigators recruiting from these populations may improve the research by incorporating methods to assess and manage distress...

..The goal of this study was to evaluate the feasibility of this strategy for identifying hospice patients who are interested in research participation...

..Although chronic pain patients' willingness to enroll in research was related to pain severity and a desire for better pain management, cancer patients' willingness to enroll was not...

..Instead, we suggest three principles that can guide the development of hospice-appropriate safety measures by considering a patient's goals and life expectancy, and the degree to which responsibility for a patient's care is shared...

..HIV infection has become a manageable chronic disease. There are few studies of pain and symptoms in the current treatment era...

..For each, we outline salient issues and suggest recommendations for enhancing the ethics of MBO studies, including interventional trials...

..Its prognostic value in a heterogeneous US hospice population is unknown...

..The group recommended a period of innovation and evaluation to refine the framework for ethical conduct of QI and to integrate that framework into clinical practice...

..This perception varies substantially among the participating hospice programs. Future research is needed to understand this variation and how hospice programs are delivering high quality of care despite short length of stay...

..The VA's experience serves as a powerful example of the magnitude of change possible in a complex health system and a model for improving access and quality of palliative care services in other health systems...

..Greater adherence to certain attributes of effective communication of bad news may improve the way physicians perform this difficult task...

..However, it is not known whether patients and their families believe that they are enrolling in hospice too late...

..Further work is needed to refine the reporting of survival times/probabilities and to improve prediction accuracy with the inclusion of other variables in the models...