AI Article Synopsis
- The study aims to understand the language used around dying in hospitals, focusing on how terminology affects decisions about life-sustaining treatment (LST) and advance care planning.
- It analyzes clinical data from inpatients over a year using a technique called natural language processing to find phrases related to "Ceiling of Treatment" and their connection to patient prognosis.
- Results show that certain phrases closely related to end-of-life care, like "Withdrawal of care," have high mortality rates, emphasizing the need for precise language in discussing LST and end-of-life options.
Article Abstract
Objectives: To clarify real-world linguistic nuances around dying in hospital as well as inaccuracy in individual-level prognostication to support advance care planning and personalised discussions on limitation of life sustaining treatment (LST).
Design: Retrospective cross-sectional study of real-world clinical data.
Setting: Secondary care, urban and suburban teaching hospitals.
Participants: All inpatients in 12-month period from 1 October 2018 to 30 September 2019.
Methods: Using unsupervised natural language processing, word embedding in latent space was used to generate phrase clusters with most similar semantic embeddings to 'Ceiling of Treatment' and their prognostication value.
Results: Word embeddings with most similarity to 'Ceiling of Treatment' clustered around phrases describing end-of-life care, ceiling of care and LST discussions. The phrases have differing prognostic profile with the highest 7-day mortality in the phrases most explicitly referring to end of life-'Withdrawal of care' (56.7%), 'terminal care/end of life care' (57.5%) and 'un-survivable' (57.6%).
Conclusion: Vocabulary used at end-of-life discussions are diverse and has a range of associations to 7-day mortality. This highlights the importance of correct application of terminology during LST and end-of-life discussions.
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|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8557276 | PMC |
| http://dx.doi.org/10.1136/bmjhci-2021-100464 | DOI Listing |
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