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

Angelo E. Volandes, Michael K. Paasche-Orlow, Susan L. Mitchell, Areej El-Jawahri, Aretha Delight Davis, Michael J. Barry, Kevan L. Hartshorn, Vicki Ann Jackson, Muriel R. Gillick, Elizabeth S. Walker-Corkery, Yuchiao Chang, Lenny López, Margaret Kemeny, Linda Bulone, Eileen Mann, Sumi Misra, Matt Peachey, Elmer D. Abbo, April F. Eichler, Andrew S. EpsteinAriela Noy, Tomer T. Levin, Jennifer S. Temel

Research output: Contribution to journalArticlepeer-review

140 Scopus citations

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

Original languageEnglish
Pages (from-to)380-386
Number of pages7
JournalJournal of Clinical Oncology
Volume31
Issue number3
DOIs
StatePublished - 20 Jan 2013

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