JAMA : the journal of the American Medical Association
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Randomized Controlled Trial Multicenter Study Clinical Trial Controlled Clinical Trial
A controlled trial to improve care for seriously ill hospitalized patients. The study to understand prognoses and preferences for outcomes and risks of treatments (SUPPORT). The SUPPORT Principal Investigators.
To improve end-of-life decision making and reduce the frequency of a mechanically supported, painful, and prolonged process of dying. ⋯ The phase I observation of SUPPORT confirmed substantial shortcomings in care for seriously ill hospitalized adults. The phase II intervention failed to improve care or patient outcomes. Enhancing opportunities for more patient-physician communication, although advocated as the major method for improving patient outcomes, may be inadequate to change established practices. To improve the experience of seriously ill and dying patients, greater individual and societal commitment and more proactive and forceful measured may be needed.
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To describe the case characteristics of a series of patients poisoned with carbon monoxide (CO) while boating for recreation. ⋯ Carbon monoxide poisoning is a serious hazard associated with recreational boating. The installation of CO detectors aboard boat types typically associated with this syndrome should be strongly encouraged.
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To evaluate long-term survival of black and white prostate cancer patients in an equal-access medical care system to help distinguish biological from medical and social explanations of mortality differences. ⋯ This analysis suggests that in an equal-access medical care system there are no stage-specific differences in treatment between black and white prostate cancer patients. Survival among blacks is similar to that among whites and may surpass it for high-stage disease.