Communicating About Mortality in Health Decision Support: 'What and Why and When, and How and Where and Who'.
Stud Health Technol Inform
; 285: 31-38, 2021 Oct 27.
Article
in English
| MEDLINE | ID: covidwho-1502261
ABSTRACT
The Covid-19 pandemic has only accelerated the need and desire to deal more openly with mortality, because the effect on survival is central to the comprehensive assessment of harms and benefits needed to meet a 'reasonable patient' legal standard. Taking the view that this requirement is best met through a multi-criterial decision support tool, we offer our preferred answers to the questions of What should be communicated about mortality in the tool, and How, given preferred answers to Who for, Who by, Why, When, and Where. Summary measures, including unrestricted Life Expectancy and Restricted Mean Survival Time are found to be reductionist and relative, and not as easy to understand and communicate as often asserted. Full lifetime absolute survival curves should be presented, even if they cannot be 'evidence-based' beyond trial follow-up limits, along with equivalent measures for other criteria in the (necessarily) multi-criterial decision. A decision support tool should relieve the reasonable person of the resulting calculation burden.
Keywords
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Decision Support Systems, Clinical
/
Advance Care Planning
Type of study:
Cohort study
/
Prognostic study
/
Randomized controlled trials
Limits:
Humans
Language:
English
Journal:
Stud Health Technol Inform
Journal subject:
Medical Informatics
/
Health Services Research
Year:
2021
Document Type:
Article
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