Advance care planning evaluation in hospitalised elderly patients: a multicenter, prospective study (The ACCEPT Study)
Bibliographic record
Abstract
We conducted a multicenter, prospective audit to evaluate the quantity and quality of advance care planning (ACP) in 12 cities in Canada. Using validated questionnaires, we conducted face to face interviews with hospitalised patients who had advanced illness and/or their family members about their pre-hospital ACP. 123 patients (average age 80±9 years) and 77 family members (average age 62±13) participated. Preliminary data documented that, in the event of future incapacitation due to illness, 84 (68.3%) of patients had formally designated someone to represent them concerning medical treatment decisions; 67 (54.5%) had written documentation describing the medical treatments they would want or not; 100 (81.3%) had ever thought about what kinds of life-sustaining treatments they would want or not and 84 (84.0%) had discussed their wishes with family members, or with their doctor (27 (27.0%). In 77 family members (average age 62±13), we found that in the event of future incapacitation due to illness, 51 (66.2%) reported that their relative (the patient) had formally designated someone to represent them concerning medical treatment decisions; 40 (52.0%) reported that their relative had written documentation describing the medical treatments they would want or not; 67 (87.0%) had ever thought about what kinds of life-sustaining treatments they would want for their relative and 55 (82.1%) had discussed these wishes with the patient, or with their family doctor (14 (20.9%). Large numbers of patients have not completed key components of ACP by the time that they are hospitalised and are at high-risk for dying.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".