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LINDVALL, Charlotta

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Measure scan and synthesis of palliative and end-of-life process quality measures for advanced cancer

O'HANLON, Claire E. ; LINDVALL, Charlotta ; LORENZ, Karl A. ; GIANNITRAPANI, Karleen F. ; GARRIDO, Melissa ; ASCH, Steven M. ; WENGER, Neil ; MALIN, Jennifer ; DY, Sydney Morss ; CANNING, Mark ; GAMBOA, Raziel C. ; WALLING, Anne M.
JCO oncology practice, 06/08/2020, Pagination inconnue

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Advance care planning: promoting effective and aligned communication in the elderly (ACP-PEACE) - the study protocol for a pragmatic stepped-wedge trial of older patients with cancer

LAKIN, Joshua R. ; BRANNEN, Elise N. ; TULSKY, James A. ; PAASCHE-ORLOW, Michael K. ; LINDVALL, Charlotta ; CHANG, Yuchiao ; GUNDERSEN, Daniel A. ; EL-JAWAHRI, Areej ; VOLANDES, Angelo ; ACP-PEACE INVESTIGATORS
BMJ Open, 14/07/2020, vol.10, n°7, p. 1-10

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Adherence and concordance between serious illness care planning conversations and oncology clinician documentation among patients with advanced cancer

GEERSE, Olaf P. ; LAMAS, Daniela J. ; BERNACKI, Rachelle E. ; SANDERS, Justin J. ; PALADINO, Joanna ; BERENDSEN, Annette J. ; HILTERMANN, Thijo J.N. ; LINDVALL, Charlotta ; FROMME, Erik K. ; BLOCK, Susan D.
JOURNAL OF PALLIATIVE MEDICINE, 22/06/2020, Pagination inconnue

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Thème : Soins.

COMMUNICATION ; PROJET SOIN ANTICIPE ; CANCER ; GUIDE ; RELATION PERSONNEL SOIGNANT PATIENT

Background: Serious illness conversations are part of advance care planning (ACP) and focus on prognosis, values, and goals in patients who are seriously ill. To be maximally effective, such conversations must be documented accurately and be easily accessible.
Objectives: The two coprimary objectives of the study were to assess concordance between written documentation and recorded audiotaped conversations, and to evaluate adherence to the Serious Illness Conversation Guide questions.
Methods: Data were obtained as part of a trial in patients with advanced cancer. Clinicians were trained to use a guide to conduct and document serious illness conversations. Conversations were audiotaped. Two researchers independently compared audiorecordings with the corresponding documentation in an electronic health record (EHR) template and free-text progress notes, and rated the degree of concordance and adherence.
Results: We reviewed a total of 25 audiorecordings. Clinicians addressed 87% of the conversation guide elements. Prognosis was discussed least frequently, only in 55% of the patients who wanted that information. Documentation was fully concordant with the conversation 43% of the time. Concordance was best when documenting family matters and goals, and least frequently concordant when documenting prognostic communication. Most conversations (64%) were documented in the template, a minority (28%) only in progress notes and two conversations (8%) were not documented. Concordance was better when the template was used (62% vs. 28%).
Conclusion: Clinicians adhered well to the conversation guide. However, key information elicited was documented and fully concordant less than half the time. Greater concordance was observed when clinicians used a prespecified template. The combined use of a guide and EHR template holds promise for ACP conversations.

Origine : DOI.org (Crossref

Natural language processing accurately measures adherence to best practice guidelines for palliative care in trauma

LEE, Katherine C. ; UDELSMAN, Brooks V. ; STREID, Jocelyn ; CHANG, David C. ; SALIM, Ali ; LIVINGSTON, David H. ; LINDVALL, Charlotta ; COOPER, Zara
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT, 02/2020, vol.59, n°2, p. 225-232

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Thème : Médecine. Cote : e00.07JPS

DEMARCHE PALLIATIVE ; COMMUNICATION ; CHIRURGIE ; TRAUMATISME

CONTEXT: The Trauma Quality Improvement Program Best Practice Guidelines recommend palliative care (PC) concurrent with restorative treatment for patients with life-threatening injuries. Measuring PC delivery is challenging: administrative data are nonspecific, and manual review is time intensive.
OBJECTIVES: To identify PC delivery to patients with life-threatening trauma and compare the performance of natural language processing (NLP), a form of computer-assisted data abstraction, to administrative coding and gold standard manual review.
METHODS: Patients 18 years and older admitted with life-threatening trauma were identified from two Level I trauma centers (July 2016-June 2017). Four PC process measures were examined during the trauma admission: code status clarification, goals-of-care discussion, PC consult, and hospice assessment. The performance of NLP and administrative coding were compared with manual review. Multivariable regression was used to determine patient and admission factors associated with PC delivery.
RESULTS: There were 76,791 notes associated with 2093 admissions. NLP identified PC delivery in 33% of admissions compared with 8% using administrative coding. Using NLP, code status clarification was most commonly documented (27%), followed by goals-of-care discussion (18%), PC consult (4%), and hospice assessment (4%). Compared with manual review, NLP performed more than 50 times faster and had a sensitivity of 93%, a specificity of 96%, and an accuracy of 95%. Administrative coding had a sensitivity of 21%, a specificity of 92%, and an accuracy of 68%. Factors associated with PC delivery included older age, increased comorbidities, and longer intensive care unit stay.
CONCLUSION: NLP performs with similar accuracy with manual review but with improved efficiency. NLP has the potential to accurately identify PC delivery and benchmark performance of best practice guidelines.

Origine : PubMed

A pilot study to evaluate compliance with guidelines for preprocedural reconsideration of code status limitations

URMAN, Richard D. ; LILLEY, Elizabeth J. ; CHANGALA, Marguerite ; LINDVALL, Charlotta ; HEPNER, David L. ; BADER, Angela M.
JOURNAL OF PALLIATIVE MEDICINE, 08/2018, vol.21, n°8, p. 1152-1156

Natural language processing to assess palliative care and end-of-life process measures in patients with breast cancer with leptomeningeal disease

BRIZZI, Kate ; ZUPANC, Sophia N. ; UDELSMAN, Brooks V. ; TULSKY, James A. ; WRIGHT, Alexi A. ; POORT, Hanneke ; LINDVALL, Charlotta
The American journal of hospice and palliative care, 05/2020, vol.37, n°5, p. 371-376

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Variation in serious illness communication among surgical patients receiving palliative care

UDELSMAN, Brooks V. ; LEE, Katherine C. ; LILLEY, Elizabeth J. ; CHANG, David C. ; LINDVALL, Charlotta ; COOPER, Zara
JOURNAL OF PALLIATIVE MEDICINE, 03/2020, vol.23, n°3, p. 411-414

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Deficits in the palliative care process measures in patients with advanced pancreatic cancer undergoing operative and invasive nonoperative palliative procedures

UDELSMAN, Brooks V. ; LILLEY, Elizabeth J. ; QADAN, Motaz ; CHANG, David C. ; LILLEMOE, Keith D. ; LINDVALL, Charlotta ; COOPER, Zara
Annals of surgical oncology, 28/08/2019, p. 1-9

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Documentation of palliative and end-of-life care process measures among young adults who died of cancer - a natural language processing approach

POORT, Hanneke ; ZUPANC, Sophia N. ; LEITER, Richard E. ; WRIGHT, Alexi A. ; LINDVALL, Charlotta
Journal of adolescent and young adult oncology, 14/08/2019, p. 1-5

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Deep learning algorithms to identify documentation of serious illness conversations during intensive care unit admissions

CHAN, Alex ; CHIEN, Isabel ; MOSELEY, Edward ; SALMAN, Saad ; KAMINER BOURLAND, Sarah ; LAMAS, Daniela ; WALLING, Anne M. ; TULSKY, James A. ; LINDVALL, Charlotta
PALLIATIVE MEDICINE, 02/2019, vol.33, n°2, p. 187-196

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Natural language processing to assess end-of-life quality indicators in cancer patients receiving palliative surgery

LINDVALL, Charlotta ; LILLEY, Elizabeth J. ; ZUPANC, Sophia N. ; CHIEN, Isabel ; UDELSMAN, Brooks V. ; WALLING, Anne ; COOPER, Zara ; TULSKY, James A.
JOURNAL OF PALLIATIVE MEDICINE, 02/2019, vol.22, n°2, p. 183-187

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Needle in a haystack - natural language processing to identify serious illness

UDELSMAN, Brooks ; CHIEN, Isabel ; OUCHI, Kei ; BRIZZI, Kate ; TULSKY, James A. ; LINDVALL, Charlotta
JOURNAL OF PALLIATIVE MEDICINE, 02/2019, vol.22, n°2, p. 179-182

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Postoperative outcomes in patients with a do-not-resuscitate (DNR) order undergoing elective procedures

BROVMAN, Ethan Y. ; WALSH, Elisa C. ; BURTON, Brittany N. ; KUO, Christine E. ; LINDVALL, Charlotta ; GABRIEL, Rodney A. ; URMAN, Richard D.
Journal of clinical anesthesia, 18/05/2018, vol.48, p. 81-88

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Measuring processes of care in palliative surgery - a novel approach using natural language processing

LILLEY, Elizabeth J. ; LINDVALL, Charlotta ; LILLEMOE, Keith D. ; TULSKY, James A. ; WIENER, Daniel C. ; COOPER, Zara
Annals of surgery, 05/2018, vol.267, n°5, p. 823-825

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Using electronic health records for quality measurement and accountability in care of the seriously ill - opportunities and challenges

CURTIS, J. Randall ; SATHITRATANACHEEWIN, Seelwan ; STARKS, Helene ; LEE, Robert Y. ; KROSS, Erin K. ; DOWNEY, Lois ; SIBLEY, James ; LOBER, William ; LOGGERS, Elizabeth T. ; FAUSTO, James A. ; LINDVALL, Charlotta ; ENGELBERG, Ruth A.
JOURNAL OF PALLIATIVE MEDICINE, 03/2018, vol.21, n°S2, p. S52-S60

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