Using modeling to inform patient-centered care choices at the end of life.

ABSTRACT:

Aim

Advance directives are often under-informed due to a lack of disease-specific prognostic information. Without well-informed advance directives patients may receive default care that is incongruent with their preferences. We aimed to further inform advance care planning in patients with severe chronic obstructive pulmonary disease by estimating outcomes with alternative advance directives.

Methods

We designed a Markov microsimulation model estimating outcomes for patients choosing between the Full Code advance directive (permitting invasive mechanical ventilation), and the Do Not Intubate directive (only permitting noninvasive ventilation).

Results

Our model estimates Full Code patients have marginally increased one-year survival after admission for severe respirat

SUBMITTER: Hajizadeh N 

PROVIDER: S-EPMC3914667 | biostudies-literature | 2013 Sep

REPOSITORIES: biostudies-literature