{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:11:18Z","timestamp":1785420678342,"version":"3.56.0"},"reference-count":40,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T00:00:00Z","timestamp":1777334400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"crossref","award":["MSTAR Training Grant through NIA\/NIH 5T35AG038027-"],"award-info":[{"award-number":["MSTAR Training Grant through NIA\/NIH 5T35AG038027-"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100015348","name":"Cambia Health Foundation","doi-asserted-by":"crossref","award":["Sojourns Scholars Leadership Program"],"award-info":[{"award-number":["Sojourns Scholars Leadership Program"]}],"id":[{"id":"10.13039\/100015348","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000867","name":"Robert Wood Johnson Foundation","doi-asserted-by":"crossref","award":["Harold Amos Medical Faculty Development Program"],"award-info":[{"award-number":["Harold Amos Medical Faculty Development Program"]}],"id":[{"id":"10.13039\/100000867","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000936","name":"Gordon and Betty Moore Foundation","doi-asserted-by":"crossref","award":["The Betty Irene Moore Fellowship for Nurse Leaders"],"award-info":[{"award-number":["The Betty Irene Moore Fellowship for Nurse Leaders"]}],"id":[{"id":"10.13039\/100000936","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Documentation of goals-of-care conversations (GOCC) in the electronic health record (EHR) is considered a cornerstone of high-quality cancer care. When done well, it can support treatment decisions that are informed by patients\u2019 values, preferences, and priorities and serve as a critical communication tool across the health care team. Although inpatient and palliative care settings have been studied extensively, less is known about GOCC documentation in outpatient oncology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>We examined the prevalence of GOCC documentation among older adults with advanced cancer in the outpatient setting and identified patient-level factors related to documentation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>\n                      We conducted a retrospective cohort study using natural language processing (NLP)-assisted chart review to identify documentation of GOCC. Advanced cancer was defined using a validated algorithm based on billing codes. Univariate analyses employed Mann\u2013Whitney\n                      <jats:italic toggle=\"yes\">U<\/jats:italic>\n                      tests for continuous variables and chi-square tests for categorical variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Subjects:<\/jats:title>\n                    <jats:p>The cohort included older adults aged &gt;65 years with advanced cancer who received outpatient treatment at an academic cancer center in Boston, MA, between 2016 and 2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 7743 patients, 43% had at least one instance of GOCC documentation. The median age was 72 years, and 51% were female. Compared with patients without documentation, those with documentation were older (median 73 vs. 71 years,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), more often single (34% vs. 29%), and less often partnered (65% vs. 70%,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). Mortality rates were also higher among patients with documentation: 6-month mortality was 23% versus 13% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), and 12-month mortality was 44% versus 23% (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). No significant differences were observed by gender, race, or Hispanic ethnicity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Fewer than half of older adults with advanced cancer had documented GOCC in outpatient oncology. This gap underscores the need for scalable interventions to ensure that values and preferences are initiated and documented in routine care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10966218261446776","type":"journal-article","created":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T01:59:22Z","timestamp":1777427962000},"page":"1106-1111","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Patterns of Goals-of-Care Documentation in the Outpatient Oncology Setting: A Retrospective Cohort Study of Older Adults with Advanced Cancer"],"prefix":"10.1177","volume":"29","author":[{"given":"Jenna","family":"Laidley","sequence":"first","affiliation":[{"name":"UMass Chan Medical School, Worcester, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel R.","family":"Zverev","sequence":"additional","affiliation":[{"name":"New York University Grossman Long Island School of Medicine, Mineola, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Kwok","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kate","family":"Sciacca","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Boston, Massachusetts, USA."},{"name":"Division of Palliative Medicine, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin Fayyazuddin","family":"Ljungberg","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soujanya","family":"Samineni","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorinda A.","family":"Coombs","sequence":"additional","affiliation":[{"name":"School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA."},{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James A.","family":"Tulsky","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Boston, Massachusetts, USA."},{"name":"Division of Palliative Medicine, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA."},{"name":"Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3674-2351","authenticated-orcid":false,"given":"Charlotta","family":"Lindvall","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Boston, Massachusetts, USA."},{"name":"Division of Palliative Medicine, Department of Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA."},{"name":"Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8075-9735","authenticated-orcid":false,"given":"Tamryn F.","family":"Gray","sequence":"additional","affiliation":[{"name":"Dana-Farber Cancer Institute, Boston, Massachusetts, USA."},{"name":"School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA."},{"name":"Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,28]]},"reference":[{"key":"e_1_3_2_2_1","doi-asserted-by":"publisher","DOI":"10.21037\/apm-23-504"},{"key":"e_1_3_2_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2020.06.002"},{"key":"e_1_3_2_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2017.09.024"},{"issue":"1","key":"e_1_3_2_5_1","article-title":"Analyzing goals of care in advanced cancer patients and their family caregivers: Evidence-based research","volume":"2","author":"Douglas SL","year":"2018","unstructured":"4.Douglas SL, , Lipson AR, , Daly BJ. 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