Use of the Electronic Medical Record to Screen Code Status Preference Using Death Language

Conditions

• Code Status Discussions With Medical In-patients

Eligibility Criteria

Sex

ALL

Age

65 Years - N/A

Healthy Volunteers

Accepted

Interventions

• Death language — BEHAVIORAL
  We will explicitly mention death when letting the participant know about CPR

Study Details

In order to systematically improve code status communication and documentation while clarifying how providers understand code status decisions, we propose the Choice of Diction's Effect Electronic Measures of Resuscitation Study Inpatient (CODE-EMRS.I) with 3 aims: Aim 1 - Determine rate of patient utilization of code status invitation (research) via the Portal (Hypothesis 1: Participants with an existing Portal are more likely to participate in research than new signups); Aim 2 - Evaluate different phrasings in code status prompts with and without death language (Hypothesis 2: Participants are more likely to pick no code with death language than without); Aim 3 - Determine how objective data drives physician agreement on code status decision (Hypothesis 3: Physicians are more likely to disagree with full code decisions for poor GO-FAR, but not CCI). Participants will fill out all study questionnaires electronically, but have options within these to ask to speak to a study physician/their own physician for clarification. After completing the surveys, the research associate will deliver the patient's code status decision to the attending of record and ask their views on it. Once a week, participants who have expressed interest in the study (by clicking the "I am interested" button) but have not completed the study will receive a reminder to complete the study as well as an offer to withdraw from the study in that same communication.

Key Dates

Start date

Feb 9, 2026

Status verified

Feb 2026

Primary completion

Jun 30, 2027

Completion

Jun 30, 2027

Study Design

Enrollment

118 participants (estimated)

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

HEALTH_SERVICES_RESEARCH

Arms

• Experimental: Experimental/Death language
  Participants will be asked: The purpose of this trial is to understand how the words we use to describe CPR affect patient decisions. Cardiopulmonary resuscitation (CPR) is performed when the heart stops beating. It consists of electric shocks to the heart, pumping the chest to circulate blood, and using a breathing machine to help with breathing. The success rate of CPR is about 1 in 7, and even when the heart restarts, the brain and other organs can be damaged. If your heart were to stop beating and you were to die without resuscitation, would you prefer that we attempt cardiopulmonary resuscitation (CPR), or would you prefer that we do not resuscitate (DNR)?
• No Intervention: Standard/non-death language
  Participants will be asked: The purpose of this trial is to understand how the words we use to describe CPR affect patient decisions. Cardiopulmonary resuscitation (CPR) is performed when the heart stops beating. It consists of electric shocks to the heart, pumping the chest to circulate blood, and using a breathing machine to help with breathing. The success rate of CPR is about 1 in 7, and even when the heart restarts, the brain and other organs can be damaged. If your heart were to stop beating, would you prefer that we attempt cardiopulmonary resuscitation (CPR), or would you prefer that we do not resuscitate (DNR)?

Primary Outcome Measure

Code status decision [ Time Frame: At enrollment ]

Central Contacts

• Karthik J Kota, MD MPH
  732-235-7112
  [email protected]

Locations (1)

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