Randomized Controlled Trial of a Video Decisions Support Tool for Cardiopulmonary Resuscitation Decision Making in Advanced Cancer 

Volandes AE, Paasche-Orlow MK, MItchell SL, El-Jawahri A, Davis AD, Barry MJ, Jackson VA, Gilick MR, Walker-Corkery ES, Chang Y, Lopez L, Bulone L, Mann E, Misra S, Peachey M, Abbo ED, Eichler AF, Epstein AD, Noy A, Levin TT, Temel JS. Randomized controlled trial of a video decision support tool for cardiopulmonary resuscitation decision making in advanced cancer. J Clin Oncol. 2013 Jan 20;31(3):380-6.

Knowledge Level

Subjects in the video arm had more accurate knowledge about CPR than the subjects in the verbal arm.

Patient Preferences: CPR

Yes to CPR (Verbal Arm)

Yes to CPR (Video Arm)

Protocol

People with Advanced Cancer

Outpatient Oncology Clinics

minute video

What Patients Think

would recommend the video to others

Comfortable watching the video

Find the video helpful.

Use of Video to Facilitate End-of-Life Discussions With Patients With Cancer: A Randomized Controlled Trial

El-Jawahri A, Podgurski LM, Eichler AF, Plotkin SR, Temel JS, Mitchell SL, ChangY, Barry MJ, Volandes AE. “Use of video to facilitate end-of-life discussions with patients with cancer: a randomized controlled trial.” J Clin Oncol. 2010 Jan 10;28(2):305-10. Epub 2009 Nov 30.

Knowledge Level

Subjects in the video arm were more knowledgeable and certain of their decisions compared to the subjects in the verbal arm.

Patient Preferences: CPR

Patient Preferences: Goals of Care

Yes to CPR (Verbal Arm)

Verbal Arm

CPR: 41% wanted CPR, 59% did not want CPR.

Yes to CPR (Video Arm)

Video Arm

CPR: 9% wanted CPR. 91% did not want CPR.

study-graph-jco
Verbal Arm

Goals of Care: 26% wanted Life Prolonging Care, 52% wanted Limited Medical Care, 23% wanted Comfort Care.

Video Arm

Goals of Care: 0% wanted Life Prolonging Care, 4% wanted Limited Medical Care, 91% wanted Comfort Care.

Protocol

People with Malignant Glioma

Multiple

Outpatient Oncology Clinics

minute video

What Patients Think

would recommend the video to others

Comfortable watching the video

Find the video helpful.

Video Decision Support Tool for Advance Care Planning in Dementia: Randomized Controlled Trial

Volandes AE, Paasche-Orlow MK, Barry MJ, Gillick MR, Minaker KL, Chang Y, Cook EF, Abbo ED, El-Jawahri A, Mitchell SL. Video decision support tool for advance care planning in dementia: randomised controlled trial. BMJ. 2009 May 28.

Knowledge Level

Subjects in the video arm were more knowledgeable about advanced dementia and goals of care preferences than the subjects in the verbal arm.

Patient Preferences: Goals of Care

study-graph-dementia-study-2

Verbal Arm

14% wanted Life Prolonging Care

19% wanted Limited Medical Care

64% wanted Comfort Care

After six weeks 27% had changed their preference.

Video Arm

4% wanted Life Prolonging Care

9% wanted Limited Medical Care

86% wanted Comfort Care

After six weeks 6% had changed their preference.

Stability of Preferences

Patients using the video decision support had more stable preferences for end of life care over time.

Protocol

People (Age 65+)

Primary Care Clinics
(2 Urban; 2 Suburban)

minute video

What Patients Think

would recommend the video to others.

comfortable watching the video.

find the video helpful.

A Randomized Controlled Trial of a Goals-of-Care Video for Elderly Patients Admitted to Skilled Nursing Facilities

Volandes AE, Brandeis GH, Davis AD, Paasche-Orlow MK, Gillick MR, Chang Y, Walker-Corker ES, Mann E, Mitchell SL. A randomized controlled trial of a goals-of-care video for elderly patients admitted to skilled nursing facilities. J Palliat Med. 2012 May 4.

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evidence-study-randomized-controlled-trial-elderly-legend

Protocol

  1. 6 minute video of the Goals of Care
  2. Randomized controlled trial of 101 elderly patients admitted to a skilled nursing facility
  3. Developed and edited with an expert panel of geriatricians

Viewing Experience

Comfort with the Video: 90% of participants were comfortable watching the video.  86% of subjects would recommend the video to other patients.

Preferences

Verbal Arm: 33% wanted Life Prolonging Care. 8% wanted Limited Care, 57% wanted Comfort Care.

Video Arm: 12% wanted Life Prolonging Care. 8% wanted Limited Care, 80% wanted Comfort Care.

What Patients Think

would recommend the video to others

Comfortable watching the video

Find the video helpful.

Publications

Augmenting communication and decision making in the intensive care unit with a cardiopulmonary resuscitation video decision support tool: a temporal intervention study.

McCannon JB1, O'Donnell WJ, Thompson BT, El-Jawahri A, Chang Y, Ananian L, Bajwa EK, Currier PF, Parikh M, Temel JS, Cooper Z, Wiener RS, Volandes AE.

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Improving decision making at the end of life with video images

Volandes AE, Barry MJ, Chang Y and Paasche-Orlow MK. "Improving decision making at the end of life with video images." Medical Decision Making, 30(1):29-34, Jan-Feb 2010.

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A Randomized Controlled Trial of a Cardiopulmonary Resuscitation Video in Advance Care Planning for Progressive Pancreas and Hepatobiliary Cancer Patients.

Epstein AS, Volandes AE, Chen LY, Gary KA, Li Y, Agre P, Levin TT, Reidy DL, Meng RD, Segal NH, Yu KH, Abou-Alfa GK, Janjigian YY, Kelsen DP, O'Reilly EM. A randomized controlled trial of cardiopulmonary resuscitation video in advance care planning for progressive pancreas and hepatobiliary cancer patients. J Palliat Med, 2013 Jun;16(6)623-31.

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It Helps Me See with My Heart: How Video Informs Patients Rationale for Decisions about Future Care in Advanced Dementia.

Deep KS, Hunter A, Murphy K, Volandes A. Patient Educ Couns. 2010 Nov;81(2):229-34.

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Randomized Controlled Trial of a Video Decision Support Tool for Cardiopulmonary Resuscitation Decision Making in Advanced Cancer

Volandes A, Paasche-Orlow MK, Mitchell SL, El-Jawahri A, Davis AD, Barry MJ, Hartshorn KL, Jackson VA, Gillick MR, Walker-Corkery ES, Change Y, Lopez L, Kemeny M, Bulone L, Mann E, Misra S, Peachey M, Abbo ED, Eichler AF, Epstein AS, Noy A, Levin TT, Temel JS, J Clin Oncol. Jan 20;31(3):380-386.

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Health Literacy Not Race Predicts End-Of-Life Care Preferences.

Volandes A, Paasche-Orlow M, Gillick M, Cook EF, Shaykevich S, Abbo E. Health literacy not race predicts end-of-life care preferences. J Palliat Med. 2008; Jun11(5):754-762.

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Overcoming Educational Barriers For Advance Care Planning In Latinos With Video Images.

Volandes A, Ariza M, Abbo E, Paasche-Orlow M. Overcoming educational barriers for advance care planning in Latinos with video images. J Palliat Med. 2008; Jun 11(5):700-706.

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Using Video Images to Improve the Accuracy of Surrogate Decision-Making: A Randomized Controlled Trial.

Volandes A, Mitchell S, Chang Y, and Paasche-Orlow M. Using Video Images to Improve the Accuracy of Surrogate Decision-Making: A Randomized Controlled Trial. J Am Med Dir Assoc, 2009 Oct;10(8):575-80.

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Assessing End-Of-Life Preferences For Advanced Dementia In Rural Patients Using An Educational Video: A Randomized Controlled Trial.

Volandes A, Ferguson LA, Davis AD, Hull NC, Green MJ, Chang Y, Deep K, and Paasche-Orlow M. Assessing end-of-life preferences for advanced dementia in rural patients using an educational video: a randomized controlled trial. J Palliat Med. 2011 Feb; 14(2): 169-77.

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Augmenting Advance Care Planning In Poor Prognosis Cancer With A Video Decision Aid: A Pre-Post Study.

Volandes A, Levin T, Slovin S, Carvajal R, O’Reilly E, Keohan M, Theodoulou M, Dickler M, Gerecitano J, Morris M, Epstein A, Naka-Blackstone A, Walker-Corkery E, Chang Y, and Noy A. Augmenting advance care planning in poor prognosis cancer with a video decision aid: a pre-post study. Cancer. 2012 Jan 17.

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A Randomized Controlled Trial Of A Goals-Of-Care Video For Elderly Patients Admitted To Skilled Nursing Facilities.

Volandes AE, Brandeis GH, Davis AD, Paasche-Orlow MK, Gillick MR, Chang Y, Walker-Corker ES, Mann E, Mitchell SL. A randomized controlled trial of a goals-of-care video for elderly patients admitted to skilled nursing facilities. J Palliat Med. 2012 May 4.

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Use Of Video To Facilitate End-Of-Life Discussions With Patients With Cancer: A Randomized Controlled Trial

El-Jawahri A, Podgurski LM, Eichler AF, Plotkin SR, Temel JS, Mitchell SL, ChangY, Barry MJ, Volandes AE. “Use of video to facilitate end-of-life discussions with patients with cancer: a randomized controlled trial.” J Clin Oncol. 2010 Jan 10;28(2):305-10. Epub 2009 Nov 30.

View Publication

Video Decision Support Tool for Advance Care Planning in Dementia: Randomised Controlled Trial

Volandes AE, Paasche-Orlow MK, Barry MJ, Gillick MR, Minaker KL, Chang Y, Cook EF, Abbo ED, El-Jawahri A, Mitchell SL. Video decision support tool for advance care planning in dementia: randomised controlled trial. BMJ. 2009 May 28;338:b2159. doi: 10.1136/bmj.b2159.

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Using Video Images Of Dementia In Advance Care Planning

Volandes A, Cook E, Shaykevich S, Abbo E, and Gillick M. Using video images of dementia in advance care planning. Archives of Internal Medicine, 2007; 167(8):828-33.

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