Predictors Of Doubt In Physicians’ Prognostications Among Surrogate Decision-Makers

Maciasz, R. M.; Hong, Seoyeon; Barnato, Amber E.; Schenker, Yael; White, Douglas B.

doi:10.1164/ajrccm-conference.2012.185.1_meetingabstracts.a5203

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2016

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“…Intensivists' concern about their ability to prognosticate post-discharge outcomes is consistent with existing literature in oncology and end-of-life care (28,29). However, intensivists may overestimate the need for precision when discussing postdischarge outcomes because surrogates do not perceive physician prognoses as absolutely accurate (30)(31)(32)(33). The vast ORIGINAL RESEARCH majority of ICU surrogates understand that uncertainty is unavoidable and want physicians to provide prognostic estimates even when uncertainty is high (34,35).…”

Section: Discussionmentioning

confidence: 67%

Intensivist-reported Facilitators and Barriers to Discussing Post-Discharge Outcomes with Intensive Care Unit Surrogates. A Qualitative Study

et al. 2016

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In this sample of intensivists from 20 academic hospitals, experience conducting conversations with surrogates and interactions with ICU survivors as outpatients were identified as facilitating discussion of expected post-discharge outcomes while optimistic surrogate expectations and prognostic uncertainty were barriers. There was tension between self-perceived ability to prognosticate and belief in a professional obligation to discuss patient outcomes.

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