{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,6]],"date-time":"2026-09-06T04:10:54Z","timestamp":1788667854738,"version":"build-2803163510"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Intensive Care Med"],"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Effective communication with surrogate decision-makers is critical in neuro-intensive care settings, where complex prognostication shapes high-stakes decision-making. To better understand how clinicians convey prognostic evidence in clinician-family meetings for patients with severe acute brain injuries (SABI), we characterized and quantified types of evidence-sharing used by clinicians in these meetings and explored their independent predictors and associations with quality of communication (QOC) and patient-centeredness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this mixed-methods study, we first qualitatively analyzed 70 transcripts of audio-recorded routine clinician-family meetings for patients with SABI. Since it provides a clear and systematic taxonomy for classifying information, we applied an established legal framework to categorize clinician statements into four evidence types: \u201c\n                      <jats:italic toggle=\"yes\">Real\u201d<\/jats:italic>\n                      (current clinical status of the patient); \u201c\n                      <jats:italic toggle=\"yes\">Documentary\u201d<\/jats:italic>\n                      (research\/literature regarding the patient's condition); \u201c\n                      <jats:italic toggle=\"yes\">Demonstrative\u201d<\/jats:italic>\n                      (diagnostic tests\/imaging to explain the clinical status); and \u201c\n                      <jats:italic toggle=\"yes\">Testimonial\u201d<\/jats:italic>\n                      (disclosure of clinician's own personal experiences). Next, we employed univariate and multivariable mixed-models to explore predictors of evidence-sharing types, as well as associations with validated measures of surrogate-perceived QOC and patient-centeredness of care.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We identified a total of 780 statements of evidence-sharing, of which the majority were \u201cReal\u201d(mean proportion 56\u2009\u00b1\u200923% across all transcripts), followed by \u201cDemonstrative\u201d(29\u2009\u00b1\u200922%), \u201cDocumentary\u201d(12\u2009\u00b1\u200915%), and \u201cTestimonial\u201d(3\u2009\u00b1\u20096%), with substantial inter-meeting variability, as indicated by wide standard deviations. In univariate analyses, longer meetings and non-Latino\/Hispanic patient ethnicity predicted more evidence-sharing statements; however, after multivariable adjustment accounting for clinician- and patient-level clustering, only meeting length remained significant. Exploratory analyses found no associations between the standardized proportion of any evidence type and surrogate-perceived QOC or patient-centeredness.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinicians\u2019 disclosure of prognostic information to families of patients with SABI varied widely in quantity and type of evidence shared. Evidence type was not associated with surrogate-perceived QOC or patient-centeredness, suggesting that factors beyond evidentiary content may shape families\u2019 communication experiences. Applying a structured framework to categorize evidence-sharing provides a novel way to systematically study prognostic communication in neurocritical care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08850666261483617","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T04:22:49Z","timestamp":1788495769000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Inside Prognostication Meetings in the Neuro-Intensive Care Unit: How Clinicians Convey Evidence to Families \u2013 A Mixed-Methods Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1547-0059","authenticated-orcid":false,"given":"Mahimasri","family":"Kotamreddy","sequence":"first","affiliation":[{"name":"University of Massachusetts Chan Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brooke","family":"Honzel","sequence":"additional","affiliation":[{"name":"University of Massachusetts Chan Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9612-7457","authenticated-orcid":false,"given":"Miriam","family":"Quinlan","sequence":"additional","affiliation":[{"name":"Anesthesiology and Critical Care Medicine, and Neurosurgery, Johns Hopkins University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raphael","family":"Carandang","sequence":"additional","affiliation":[{"name":"University of Massachusetts Chan Medical School"},{"name":"University of Massachusetts Chan Medical School"},{"name":"University of Massachusetts Chan Medical School"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susanne","family":"Muehlschlegel","sequence":"additional","affiliation":[{"name":"Anesthesiology and Critical Care Medicine, and Neurosurgery, Johns Hopkins University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,3]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2020.06.002"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ccc.2022.06.005"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-022-00644-7"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/jmp\/jhac016"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-020-00553-w"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.5271"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12028-017-0427-2"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207462"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13054-023-04693-2"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12904-021-00748-9"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare9020208"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12912-025-03417-x"},{"key":"e_1_3_2_14_2","volume-title":"Evidence (CrunchTime)","author":"Emanuel S","year":"2013","unstructured":"Emanuel S. 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