Use of the Electronic Medical Record to Screen Code Status Preference Using Death Language
For patients and families
In plain language
An automatic summary of structured registry data. It is an orientation aid, not a substitute for the official protocol or a physician assessment.
- What is being studied
- The protocol lists: Death language.
- Who it may be relevant to
- Registry conditions: Code Status Discussions With Medical In-patients. Basic parameters: from 65 years · All.
- What needs checking
- Age, condition and sex are only basic indicators. Prior treatment, laboratory values and other mandatory requirements appear in the eligibility criteria below.
- Where it takes place
- United States
- Next step
- Save the trial, show it to the treating physician, and confirm current recruitment with the study center. Costs, documents and travel →
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Official title
Choice of Diction's Effect: Electronic Measures of Resuscitation Status Inpatient
Overview
In order to systematically improve code status communication and documentation while clarifying how providers understand code status decisions, we propose the Choice of Diction's Effect Electronic Measures of Resuscitation Study Inpatient (CODE-EMRS.I) with 3 aims: Aim 1 - Determine rate of patient utilization of code status invitation (research) via the Portal (Hypothesis 1: Participants with an existing Portal are more likely to participate in research than new signups); Aim 2 - Evaluate different phrasings in code status prompts with and without death language (Hypothesis 2: Participants are more likely to pick no code with death language than without); Aim 3 - Determine how objective data drives physician agreement on code status decision (Hypothesis 3: Physicians are more likely to disagree with full code decisions for poor GO-FAR, but not CCI). Participants will fill out all study questionnaires electronically, but have options within these to ask to speak to a study physician/their own physician for clarification. After completing the surveys, the research associate will deliver the patient's code status decision to the attending of record and ask their views on it. Once a week, participants who have expressed interest in the study (by clicking the "I am interested" button) but have not completed the study will receive a reminder to complete the study as well as an offer to withdraw from the study in that same communication.
Interventions
- Behavioral Death language
We will explicitly mention death when letting the participant know about CPR
Primary outcome measures
- Code status decision [Time frame: At enrollment]
- Physician of record decision for and agreement with code status [Time frame: Within 24 hours of patient decision]
Eligibility criteria
Inclusion criteria
- Age >65, English-fluency in reading and speaking, and the capacity to consent
Exclusion criteria
- Requiring ICU-level care
Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.
Healthy volunteers: Yes
Study design
- Allocation
- Randomized
- Model
- Parallel assignment
- Masking
- Open label
- Primary purpose
- Health services research
Study locations
United States · 1 center
- Robert Wood Johnson University Hospital - New Brunswick — New Brunswick
Identifiers
NCT: NCT07405710 · Pro2025000307