{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:11:49Z","timestamp":1790122309189,"version":"4.0.1"},"reference-count":47,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T00:00:00Z","timestamp":1658448000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["Cancer Center Support Grant P30 CA008748"],"award-info":[{"award-number":["Cancer Center Support Grant P30 CA008748"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2022,9,15]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Goals of care (GOC) documentation is important but underused. We aimed to improve oncologist GOC documentation and end\u2010of\u2010life (EOL) care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In April 2020, our cancer center launched a GOC note template, including optional fields for documenting discussion with the patient about: cancer natural history, goals, and\/or EOL (resuscitation preferences, hospice receptivity). Associations between GOC notes and EOL care were evaluated.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 1721 patients dying between June 1, 2020 and June 30, 2021, median days from first GOC note (\u00b1 with documentation of EOL discussion) to death was 92, whereas a GOC note including EOL discussion (\u201cGOC EOL note\u201d), specifically, was 31. Patients with a first GOC note &gt;60\u2009days before death spent fewer days inpatient (6.7 vs 10.6\u2009days, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Among patients with GOC EOL notes, those with such documentation &gt;30\u2009days before death had fewer inpatient (5 vs 11, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001) and intensive care unit days (0.5 vs 1.5, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001), more hospice referrals (57% vs 44%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.003), and less chemotherapy \u226414\u2009days before death (6% vs 11%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.010). Of 925 admissions of patients dying within \u226430\u2009days, those with GOC EOL notes were shorter (7 vs 9\u2009days, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.013) but not associated with more hospice discharge (30% vs 25%, <jats:italic>p<\/jats:italic>\u00a0=\u00a0.163). Oncologist (vs nononcologist) GOC documentation and earlier documentation of EOL discussion were associated in subset analyses with less inpatient care and more hospice referrals.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Documentation of GOC, including EOL discussions, is associated with favorable performance on accepted indicators of quality EOL care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.34400","type":"journal-article","created":{"date-parts":[[2022,7,22]],"date-time":"2022-07-22T08:54:48Z","timestamp":1658480088000},"page":"3400-3407","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Goals of care documentation by medical oncologists and oncology patient end\u2010of\u2010life care outcomes"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1808-3070","authenticated-orcid":false,"given":"Andrew S.","family":"Epstein","sequence":"first","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York New York USA"},{"name":"Weill Cornell Medical College  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Riley","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith E.","family":"Nelson","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York New York USA"},{"name":"Weill Cornell Medical College  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0867-1688","authenticated-orcid":false,"given":"Camila","family":"Bernal","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Martin","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York New York USA"},{"name":"Weill Cornell Medical College  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han","family":"Xiao","sequence":"additional","affiliation":[{"name":"Memorial Sloan Kettering Cancer Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,7,22]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.5179"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.18603"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2010.31.9897"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2018.0015"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2014.55.8817"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1607206"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.8981"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1993.03500060083036"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1200\/jop.2013.001212"},{"key":"e_1_2_8_11_1","unstructured":"National Quality Forum: A National Framework and Preferred Practices for Palliative and Hospice Care Quality. 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