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Many Americans die in intensive care units (ICUs), often after long courses of aggressive interventions. One strategy for shared decision-making is time-limited trials of specific ICU treatments. In this model, clinicians and family members meet and discuss a patient's prognosis and decide together on a time course for certain medical therapies with a planned follow-up meeting to assess effectiveness of the intervention.
Investigators at three California hospitals studied 209 patients deemed to be at risk for nonbeneficial care before (113 patients) and after (96 patients) an educational intervention for ICU clinicians on use of time-limited trials. The intervention included discussion of barriers to time-limited trials, protocols for how to…