A theoretical decision model to help inform advance directive discussions for patients with COPD.

ABSTRACT:

Background

Advance directives (AD) may promote preference-concordant care yet are absent in many patients with Chronic Obstructive Pulmonary Disease (COPD). In order to begin to inform AD discussions between clinicians and COPD patients, we constructed a decision tree to estimate the impact of alternative AD decisions on both quality and quantity of life (quality adjusted life years, QALYs).

Methods

Two aspects of the AD were considered, Do Not Intubate (DNI; i.e., no invasive mechanical ventilation) and Full Code (i.e., may use invasive mechanical ventilation). Model parameters were based on published estimates. Our model follows hypothetical patients with COPD to evaluate the effect of underlying COPD severity and of hypothetical patient-specific preferences (about long-te

SUBMITTER: Hajizadeh N 

PROVIDER: S-EPMC3020153 | biostudies-literature | 2010 Dec

REPOSITORIES: biostudies-literature