Abstract 288: The Tool to Empower (TEMPO) Surrogate Decision Makers of Comatose Survivors of Cardiac Arrest: A Pilot Trial of a Novel Decision Tool
Bibliographic record
Abstract
Introduction: OHCA is a sudden unexpected event that frequently renders patients incapable of decision-making. Surrogate decision makers are often thrust into the position of deciphering complex medical information while representing their loved one’s wishes with little support. Hypothesis: An evidence based, iteratively designed decision tool will be feasible to deploy, acceptable to surrogates, increase knowledge of post-cardiac arrest care and impart self-efficacy for decision making. Goal: To measure the efficacy of a novel decision aid for surrogates. Methods: We conducted a pilot trial of the T ool to EMPO wer (TEMPO) decision makers to examine feasibility, acceptability, knowledge, and self-efficacy. Surrogates were given a pre-intervention survey on the day of arrest, provided the tool and a post-intervention survey at least 24 hours later. The survey included an 8-question knowledge questionnaire. The post-interventions survey included the same knowledge questions, the Ottawa acceptability survey and a measure of self-efficacy for decision-making for the unconscious patient. Results: We enrolled 41 surrogates into the TEMPO Pilot Trial between 9/20 and 12/22. Subjects identified were predominantly women (75.6%, n=31), 53.7% were White, 22% Black and 24.4% Hispanic. Participants had varied relationships to the patient including spouse (44%), sibling (17%), adult child (17%) and parent (12%). Knowledge increased from 56.4% to 85.9%, an absolute improvement of 29.5%. Significant improvements were noted in self-efficacy in the following domains after exposure to TEMPO: 1) receipt of resuscitation; 2) care at the end-of-life; and 3) continued desire to fight the disease. Surrogates found the tool to be useful (84.6%) and that it made their choice easier (91.2%). One participant reported “I had never dealt with this and did not know what to expect so the information given was very helpful” and another stated “Now I know what type of questions to ask and what to look for.” Conclusion(s): In a pilot trial of TEMPO, a novel decision tool for surrogate decision makers of comatose survivors of cardiac arrest, we found the intervention was feasible, acceptable, improved knowledge and increased feelings of self-efficacy in decision making.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.023 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
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 source (direct Gemma or distilled Codex), 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".