{"id":"https://openalex.org/W4385968827","doi":"https://doi.org/10.1089/jpm.2023.0128","title":"Effectiveness of an Algorithmic Approach to Ventilator Withdrawal at the End of Life: A Stepped Wedge Cluster Randomized Trial","display_name":"Effectiveness of an Algorithmic Approach to Ventilator Withdrawal at the End of Life: A Stepped Wedge Cluster Randomized Trial","publication_year":2023,"publication_date":"2023-08-18","ids":{"openalex":"https://openalex.org/W4385968827","doi":"https://doi.org/10.1089/jpm.2023.0128","pmid":"https://pubmed.ncbi.nlm.nih.gov/37594769","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/10825265"},"language":"en","primary_location":{"id":"doi:10.1089/jpm.2023.0128","doi":"https://doi.org/10.1089/jpm.2023.0128","is_oa":false,"landing_page_url":"https://doi.org/10.1089/jpm.2023.0128","pdf_url":null,"source":{"id":"https://openalex.org/S155536936","display_name":"Journal of Palliative Medicine","issn_l":"1096-6218","issn":["1096-6218","1557-7740"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320443","host_organization_name":"Mary Ann Liebert, Inc.","host_organization_lineage":["https://openalex.org/P4310320443","https://openalex.org/P4310320017"],"host_organization_lineage_names":["Mary Ann Liebert, Inc.","SAGE Publishing"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Palliative Medicine","raw_type":"journal-article"},"volume":null,"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"green","oa_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10825265/pdf/jpm.2023.0128.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5070034048","display_name":"Margaret Campbell","orcid":"https://orcid.org/0000-0003-4517-690X","observed_orcids":["https://orcid.org/0000-0003-4517-690X"]},"institutions":[{"id":"https://openalex.org/I185443292","display_name":"Wayne State University","ror":"https://ror.org/01070mq45","country_code":"US","type":"education","lineage":["https://openalex.org/I185443292"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Margaret L. Campbell","raw_affiliation_strings":["College of Nursing, Wayne State University, Detroit, Michigan, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"College of Nursing, Wayne State University, Detroit, Michigan, USA","institution_ids":["https://openalex.org/I185443292"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5032639920","display_name":"HOSSEIN N. YARANDI","orcid":"https://orcid.org/0000-0001-9927-8894","observed_orcids":["https://orcid.org/0000-0001-9927-8894"]},"institutions":[{"id":"https://openalex.org/I185443292","display_name":"Wayne State University","ror":"https://ror.org/01070mq45","country_code":"US","type":"education","lineage":["https://openalex.org/I185443292"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Hossein N. Yarandi","raw_affiliation_strings":["College of Nursing, Wayne State University, Detroit, Michigan, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"College of Nursing, Wayne State University, Detroit, Michigan, USA","institution_ids":["https://openalex.org/I185443292"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5070034048"],"corresponding_institution_ids":["https://openalex.org/I185443292"],"apc_list":null,"apc_paid":null,"fwci":2.8027,"has_fulltext":true,"cited_by_count":11,"citation_normalized_percentile":{"value":0.90321281,"is_in_top_1_percent":false,"is_in_top_10_percent":true},"cited_by_percentile_year":{"min":94,"max":99},"biblio":{"volume":"27","issue":"2","first_page":"185","last_page":"191"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10177","display_name":"Palliative Care and End-of-Life Issues","score":0.9878000020980835,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10177","display_name":"Palliative Care and End-of-Life Issues","score":0.9878000020980835,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10322","display_name":"Respiratory Support and Mechanisms","score":0.007699999958276749,"subfield":{"id":"https://openalex.org/subfields/2740","display_name":"Pulmonary and Respiratory Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13340","display_name":"Palliative and Oncologic Care","score":0.0020000000949949026,"subfield":{"id":"https://openalex.org/subfields/2739","display_name":"Public Health, Environmental and Occupational Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/ventilator-withdrawal","display_name":"ventilator withdrawal","score":0.9570000171661377},{"id":"https://openalex.org/keywords/end-of-life-care","display_name":"end-of-life care","score":0.9300000071525574},{"id":"https://openalex.org/keywords/weaning-from-mechanical-ventilation","display_name":"weaning from mechanical ventilation","score":0.8299999833106995},{"id":"https://openalex.org/keywords/algorithmic-approach","display_name":"algorithmic approach","score":0.5289999842643738},{"id":"https://openalex.org/keywords/respiratory-distress","display_name":"respiratory distress","score":0.8930000066757202},{"id":"https://openalex.org/keywords/patient-comfort","display_name":"patient comfort","score":0.6859999895095825},{"id":"https://openalex.org/keywords/opioid-use","display_name":"opioid use","score":0.8880000114440918},{"id":"https://openalex.org/keywords/benzodiazepine-use","display_name":"benzodiazepine use","score":0.9769999980926514},{"id":"https://openalex.org/keywords/survival-time","display_name":"survival time","score":0.5519999861717224},{"id":"https://openalex.org/keywords/palliative-care","display_name":"palliative care","score":0.5830000042915344}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8484752178192139},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.5238523483276367},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.5180814266204834},{"id":"https://openalex.org/C2994186709","wikidata":"https://www.wikidata.org/wiki/Q29483","display_name":"Palliative care","level":2,"score":0.5095382332801819},{"id":"https://openalex.org/C2780655333","wikidata":"https://www.wikidata.org/wiki/Q333203","display_name":"Weaning","level":2,"score":0.43062031269073486},{"id":"https://openalex.org/C141983124","wikidata":"https://www.wikidata.org/wiki/Q188008","display_name":"Respiratory distress","level":2,"score":0.4234764277935028},{"id":"https://openalex.org/C194828623","wikidata":"https://www.wikidata.org/wiki/Q2861470","display_name":"Emergency medicine","level":1,"score":0.3596212863922119},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.3455067276954651},{"id":"https://openalex.org/C42219234","wikidata":"https://www.wikidata.org/wiki/Q131130","display_name":"Anesthesia","level":1,"score":0.30667567253112793},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.22419705986976624},{"id":"https://openalex.org/C159110408","wikidata":"https://www.wikidata.org/wiki/Q121176","display_name":"Nursing","level":1,"score":0.10152775049209595},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.0}],"mesh":[{"descriptor_ui":"D000701","descriptor_name":"Analgesics, Opioid","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D001569","descriptor_name":"Benzodiazepines","qualifier_ui":"Q000627","qualifier_name":"therapeutic use","is_major_topic":false},{"descriptor_ui":"D003643","descriptor_name":"Death","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D004417","descriptor_name":"Dyspnea","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012121","descriptor_name":"Respiration, Artificial","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D012122","descriptor_name":"Ventilators, Mechanical","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D012128","descriptor_name":"Respiratory Distress Syndrome","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D015300","descriptor_name":"Ventilator Weaning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":3,"locations":[{"id":"doi:10.1089/jpm.2023.0128","doi":"https://doi.org/10.1089/jpm.2023.0128","is_oa":false,"landing_page_url":"https://doi.org/10.1089/jpm.2023.0128","pdf_url":null,"source":{"id":"https://openalex.org/S155536936","display_name":"Journal of Palliative Medicine","issn_l":"1096-6218","issn":["1096-6218","1557-7740"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","dongbi-b","doyens","jufo-1","ki-jl-1","medline","norway-1","poland-100","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310320443","host_organization_name":"Mary Ann Liebert, Inc.","host_organization_lineage":["https://openalex.org/P4310320443","https://openalex.org/P4310320017"],"host_organization_lineage_names":["Mary Ann Liebert, Inc.","SAGE Publishing"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of Palliative Medicine","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:10825265","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10825265","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10825265/pdf/jpm.2023.0128.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"J Palliat Med","raw_type":"Text"},{"id":"pmid:37594769","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/37594769","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of palliative medicine","raw_type":"Randomized Controlled Trial"}],"best_oa_location":{"id":"pmh:oai:pubmedcentral.nih.gov:10825265","doi":null,"is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10825265","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10825265/pdf/jpm.2023.0128.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"J Palliat Med","raw_type":"Text"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[{"id":"https://openalex.org/study-designs/randomized-controlled-trial","display_name":"Randomized Controlled Trial"},{"id":"https://openalex.org/study-designs/clinical-trial","display_name":"Clinical Trial"}],"awards":[{"id":"https://openalex.org/G8619403999","display_name":"An Algorithmic Approach to Ventilator Withdrawal at the End of Life","funder_award_id":"R01NR015768","funder_id":"https://openalex.org/F4320337353","funder_display_name":"National Institute of Nursing Research"}],"funders":[{"id":"https://openalex.org/F4320337353","display_name":"National Institute of Nursing Research","ror":"https://ror.org/01y3zfr79"}],"has_content":{"grobid_xml":true,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4385968827.pdf","grobid_xml":"https://content.openalex.org/works/W4385968827.grobid-xml"},"referenced_works_count":34,"referenced_works":["https://openalex.org/W1755690759","https://openalex.org/W1757329641","https://openalex.org/W1991339447","https://openalex.org/W2000094707","https://openalex.org/W2003265356","https://openalex.org/W2003775456","https://openalex.org/W2004733526","https://openalex.org/W2012404050","https://openalex.org/W2032039690","https://openalex.org/W2033258317","https://openalex.org/W2041806910","https://openalex.org/W2045228479","https://openalex.org/W2045932891","https://openalex.org/W2059193009","https://openalex.org/W2064437704","https://openalex.org/W2076718799","https://openalex.org/W2087484885","https://openalex.org/W2101754128","https://openalex.org/W2119254210","https://openalex.org/W2121817490","https://openalex.org/W2125362214","https://openalex.org/W2128349740","https://openalex.org/W2145237313","https://openalex.org/W2170759445","https://openalex.org/W2171471252","https://openalex.org/W2310778072","https://openalex.org/W2317659565","https://openalex.org/W2490867486","https://openalex.org/W2567172426","https://openalex.org/W2747226248","https://openalex.org/W2902041696","https://openalex.org/W3037103135","https://openalex.org/W3081158790","https://openalex.org/W4310571235"],"related_works":["https://openalex.org/W4280562969","https://openalex.org/W4409601969","https://openalex.org/W1757329641","https://openalex.org/W7100178037","https://openalex.org/W7165030948","https://openalex.org/W2011079759","https://openalex.org/W4408294279","https://openalex.org/W590332648","https://openalex.org/W2002899801","https://openalex.org/W2047885215"],"abstract_inverted_index":{"Background:The":[0],"transition":[1],"to":[2,62,69,101],"spontaneous":[3],"breathing":[4],"puts":[5],"patients":[6,169,182],"who":[7],"are":[8],"undergoing":[9,49],"ventilator":[10,127,178],"withdrawal":[11],"at":[12,93,124,126],"high":[13],"risk":[14],"for":[15,132],"developing":[16],"respiratory":[17,66,206,252],"distress.":[18],"A":[19],"patient-centered":[20],"algorithmic":[21,57],"approach":[22,35,58],"could":[23],"standardize":[24],"this":[25,50],"process":[26,145],"and":[27,129,137,163,231,275],"meet":[28],"unique":[29],"patient":[30,65,147,251],"needs":[31,44],"because":[32],"a":[33,46,176],"single":[34],"(weaning":[36],"vs.":[37],"one-step":[38,177],"extubation)":[39],"does":[40],"not":[41],"capture":[42],"the":[43,56,102,118,141,144,171,184,200,209,242,260,286],"of":[45,86,143,181,192],"heterogenous":[47],"population":[48],"palliative":[51],"procedure.":[52],"Objectives:(1)":[53],"Demonstrate":[54],"that":[55],"can":[59],"be":[60,267],"effective":[61,218,248],"ensure":[63],"greater":[64],"comfort":[67,114],"compared":[68],"usual":[70,108,172,261],"care;":[71],"(2)":[72],"determine":[73],"differences":[74],"in":[75,104,170,183,199,208,241,249,259,285],"opioid":[76],"or":[77],"benzodiazepine":[78],"use;":[79],"(3)":[80],"predict":[81],"factors":[82],"associated":[83],"with":[84,117],"duration":[85],"survival.":[87],"Design/Settings/Measures:A":[88],"stepped-wedge":[89],"cluster":[90],"randomized":[91],"design":[92],"five":[94],"sites":[95],"was":[96,115,247,257],"used.":[97],"Sites":[98],"crossed":[99],"over":[100,189],"algorithm":[103,157,185,246],"random":[105],"order":[106],"after":[107],"care":[109,152,173,262],"data":[110,153,158],"were":[111,149,165,187,239],"obtained.":[112],"Patient":[113],"measured":[116,273],"Respiratory":[119],"Distress":[120],"Observation":[121],"Scale\u00a9":[122],"(RDOS)":[123],"baseline,":[125],"off,":[128],"every":[130],"15-minutes":[131],"an":[133,190],"hour.":[134],"Parenteral":[135],"morphine":[136],"lorazepam":[138],"equivalents":[139],"from":[140],"onset":[142],"until":[146],"death":[148],"calculated.":[150],"Results:Usual":[151],"n":[154,159],"=":[155,160,213,216,221,226,229,234,237],"120,":[156],"48.":[161],"Gender":[162],"race":[164],"evenly":[166],"distributed.":[167],"All":[168],"arm":[174,186,211],"underwent":[175],"cessation;":[179],"58%":[180],"weaned":[188],"average":[191],"18":[193],"\u00b1":[194],"27":[195],"minutes":[196],"as":[197,279,281,284],"prescribed":[198],"algorithm.":[201],"Patients":[202],"had":[203],"significantly":[204],"less":[205,265],"distress":[207,270,282],"intervention":[210],"(F":[212],"10.41,":[214],"p":[215,228,236],"0.0013,":[217],"size":[219],"[es]":[220],"0.49).":[222],"More":[223],"opioids":[224],"(t":[225,233],"\u22122.30,":[227],"0.023)":[230],"benzodiazepines":[232],"\u22122.08,":[235],"0.040)":[238],"given":[240,258],"control":[243],"arm.":[244],"Conclusions:The":[245],"ensuring":[250],"comfort.":[253],"Surprisingly,":[254],"more":[255],"medication":[256],"arm;":[263],"however,":[264],"may":[266],"needed":[268],"when":[269],"is":[271,277],"objectively":[272],"(RDOS),":[274],"treatment":[276],"initiated":[278],"soon":[280],"develops":[283],"algorithm.Clinical":[287],"Trial":[288],"Registration":[289],"number:":[290],"NCT":[291],"03121391.":[292]},"counts_by_year":[{"year":2026,"cited_by_count":3},{"year":2025,"cited_by_count":6},{"year":2024,"cited_by_count":2}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2023-08-19T00:00:00"}
