Literature Review

Chatbot performance in defining and differentiating palliative care, supportive care, hospice careJ Pain Symptom Manage, by Min Ji Kim, Sonal Admane, Yuchieh Kathryn Chang, Kao-Swi Karina Shih, Akhila Reddy, Michael Tang, Maxine De La Cruz, Terry Pham Taylor, Eduardo Bruera, David Hui; 1/24We evaluated the accuracy, comprehensiveness, reliability, and readability of three AI platforms in defining and differentiating "palliative care," "supportive care," and "hospice care." We identified important concerns regarding the accuracy, comprehensiveness, reliability, and readability of outputs from AI platforms.

Early and often: Promoting early integration of pediatric palliative care for seriously ill children with cancerCurr Probl Cancer, by Sara Taub, Robert Macauley; 10/23Pediatric palliative care, despite substantial overlap with its adult counterpart, is also distinct in some ways. Serious illness and comorbidities are less common in children, for whom there is a stronger presumption toward aggressive treatment. This, along with impressive cure rates for pediatric cancer, can help explain why children typically survive for a longer period of time following initial palliative care consultation. ... Several barriers to early integration exist, however, including misperceptions that palliative care constitutes "giving up" and concerns about potential role confusion with the primary team. By directly addressing these misperceptions and challenges, it is possible for palliative care and oncology to work in constructive partnerships that will benefit children with cancer and their families.

Top read articles: Quality versus quantity of life: Beyond the dichotomyPalliative Medicine Reports, by Ariel Dempsey, John Mulder; 3/23A restrictive and dichotomous question has become the primary approach in many goals of care discussions. Is the primary goal of care quantity of life through aggressive therapy or quality of life through comfort care and hospice?Publisher note: While a little dated, this was part of a "top read in 2023" email.

Live discharge of hospice patients with Alzheimer’s Disease and related dementias: A systematic reviewAm J Hosp Palliat Care, by Stephanie P Wladkowski, Cara L Wallace, Kathryn Coccia, Rebecca C Hyde, Leslie Hinyard, Karla T Washington; 2/24Hospice is intended to promote the comfort and quality of life of dying patients and their families. When patients are discharged from hospice prior to death (ie, experience a "live discharge"), care continuity is disrupted. This systematic review summarizes the growing body of evidence on live discharge among hospice patients with Alzheimer's Disease and related dementias (ADRD), a clinical subpopulation that disproportionately experiences this often burdensome care transition.

Medical marijuana for pain management in hospice care as a complementary approach to scheduled opioids: A single arm studyAm J Hosp Palliat Care, by Theodore Zanker, Joseph Sacco, James Prota, Michelle Palma, Kyoung A Viola Lee, Ruixiao Rachel Wang, Yixuan Liang, James Cunningham, Mona Mackary, Polina Ovchinnikova; 12/23Combination medical cannabis/opioid therapy showed statistically significant pain relief and may have the potential for reducing opioid dose and mitigating opioid toxicity, offering a safe pain management alternative to opioids alone for patients in end-of-life care settings, and warrants further investigation in larger controlled trials.

Nurse and social worker palliative telecare team and quality of life in patients with COPD, heart failure, or interstitial lung disease: The ADAPT randomized clinical trialJAMA Network, by David B. Bekelman, MD, MPH; William Feser, MS; Brianne Morgan, BSN; Carolyn H. Welsh, MD; Elizabeth C. Parsons, MD; Grady Paden, MD; Anna Baron, PhD; Brack Hattler, MD; Connor McBryde, MD; Andrew Cheng, MD; Allison V. Lange, MD; David H. Au, MD, MS; 1/16/24Can a nurse and social worker palliative telecare team improve quality of life in outpatients with chronic obstructive pulmonary disease (COPD), heart failure (HF), and interstitial lung disease (ILD)? For adults with COPD, HF, or ILD at high risk of hospitalization and death and poor quality of life, a nurse and social worker palliative telecare team demonstrated clinically meaningful improvements in quality of life at 6 months.Publisher note: JAMA Network published two palliative care clinical trials in this issue (1: Default palliative care consultation for seriously ill hospitalized patients: A pragmatic cluster randomized trial, and 2: Nurse and social worker palliative telecare team and quality of life in patients with COPD, heart failure, or interstitial lung disease: The ADAPT randomized clinical trial). There is also an editorial on both of these articles: A tale of 2 palliative care trials: Developing sustainable and transferable models by Ashwin A. Kotwal, MD, MS; Lauren J. Hunt, RN, PhD; Alexander K. Smith, MD, MS, MPH, and an audio interview with Alexander K. Smith, MD, MS, MPH, Patient-centered palliative care.

Processes and lessons learned in establishing the Palliative Care Research Cooperative's Qualitative Data Repository in Serious Illness and Palliative CareOSF Preprints, by Salimah H. Meghani, Kim Mooney-Doyle, Amber Barnato, Kathryn Colborn, Riley Gillette, Krista Harrison, Pam Hinds, Dessi Kirilova, Kathleen Knafl, Dena Schulman-Green, Kathryn Pollak, Christine S. Ritchie, Jean Kutner, and Sebastian Karcher; 12/23Data sharing is increasingly an expectation in health research since implementation of the National In-stitutes of Health Data Management and Sharing Policy. Qualitative studies are not exempt from this data sharing requirement. Recognizing this trend, the Palliative Care Research Cooperative Group (PCRC) re-alized the value of creating a de-identified qualitative data repository to complement its existing de-identified quantitative data repository.

Addressing 10 myths about pediatric palliative careAM J Hosp Palliat Care, by Kim Sadler, PhD, BSN; Saadiya Khan, MD; Khaled AlGhamdi, MD; Hamad Hussain Alyami, MSN; Lori Nancarrow, MSN; 2/24With advances in biomedical sciences, a growing number of conditions affecting children have evolved from being considered life-limiting to almost chronic diseases. However, improvements in survival rates often come at a cost of increased medical complexity and lengthy hospitalizations, which can be associated with a poorer quality of life. This is where pediatric palliative care (PPC) can play a significant role. PPC is a specialty of healthcare that focuses on the prevention and relief of suffering in children with serious conditions.

The ethics of refusing lifesaving treatment following a failed suicide attemptJ Clin Ethics, by Megan K Applewhite, Jacob Mago, Wayne Shelton; Fall 2023Injuries from failed suicide attempts account for a large number of patients cared for in the emergency and trauma setting. While a fundamental underpinning of clinical ethics is that patients have a right to refuse treatment, individuals presenting with life-threating injuries resulting from suicide attempts are almost universally treated in this acute care setting. Here we discuss the limitations on physician ability to determine capacity in this setting and the challenges these pose in carrying out patient wishes.Editor's note: An interesting ethical analysis of care following a suicide attempt that hospice professionals may find helpful.

Place of death before and during the COVID-19 pandemicJAMA Network, by Ben Teasdale, MPhil; Aditya Narayan, BS; Stephanie Harman, MD; Kevin A. Schulman, MD; 1/8/24As recently as 2015, dying at home became more common than dying in a hospital. The COVID-19 pandemic interrupted these trends, as the acute clinical course of severe infection shifted deaths back inside hospitals. Beyond the direct consequence of pandemic-related mortality, indirect associations of factors, such as workforce and resource limitations, disrupted the provision of end-of-life care more broadly, even for patients who were not directly infected with COVID-19. Three years after the start of the pandemic, we investigate the national and ongoing impact of the COVID-19 pandemic and place of death among individuals in the US.

What's in This For You? What's in This For Me?: A Win-Win Perspective of Involving Study Advisory Committee Members in Palliative Care ResearchJ Patient Exp., by Juanita Booker-Vaughns, Dawn Rosini, Romilla Batra, Garrett K Chan, Patrick Dunn, Robert Galvin, Ernest Hopkins 3rd, Eric Isaacs, Constance L Kizzie-Gillett, Margaret Maguire, Martha Navarro, Neha Reddy Pidatala, William Vaughan, Sally Welsh, Pluscedia Williams, Angela Young-Brinn, Kaitlyn Van Allen, Allison M Cuthel, Rebecca Liddicoat Yamarik, Mara Flannery, Keith S Goldfeld, Corita R Grudzen; 1/24Study advisory committees (SACs) provide critical value to clinical trials by providing unique perspectives that pull from personal and professional experiences related to the trial's healthcare topic. The Emergency Medicine Palliative Care Access (EMPallA) study had the privilege of convening a 16-person SAC from the project's inception to completion. The study team wanted to understand the impact this project had on the SAC members. In this narrative, we use reflective dialogue to share SAC members' lived experiences and the impact the EMPallA study has had on members both personally and professionally. We detail the (1) benefits SAC members, specifically patients, and caregivers, have had through working on this project. (2) The importance of recruiting diverse SAC members with different lived experiences and leveraging their feedback in clinical research. (3) Value of community capacity building to ensure the common vision of the clinical trial is promoted.

Measuring the impact of AI in the diagnosis of hospitalized patientsJAMA Network, by Sarah Jabbour, MSE; David Fouhey, PhD; and Stephanie Shepard, PhD; Thomas S. Valley, MD; Ella A Kazerooni, MD, MS; Nikola Banovic, PhD; Jenna Wiens, PhD; Michael W. Sjoding, MD; 12/23In this multicenter randomized clinical vignette survey study, diagnostic accuracy significantly increased by 4.4% when clinicians reviewed a patient clinical vignette with standard AI model predictions and model explanations compared with baseline accuracy. However, accuracy significantly decreased by 11.3% when clinicians were shown systematically biased AI model predictions and model explanations did not mitigate the negative effects of such predictions.