{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T12:54:55Z","timestamp":1776948895980,"version":"3.51.4"},"reference-count":29,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"3","content-domain":{"domain":["ascopubs.org"],"crossmark-restriction":true},"short-container-title":["JCO"],"published-print":{"date-parts":[[2023,1,20]]},"abstract":"<jats:sec><jats:title>PURPOSE<\/jats:title><jats:p> Many hospitals have established goals-of-care programs in response to the coronavirus disease 2019 pandemic; however, few have reported their outcomes. We examined the impact of a multicomponent interdisciplinary goals-of-care program on intensive care unit (ICU) mortality and hospital outcomes for medical inpatients with cancer. <\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p> This single-center study with a quasi-experimental design included consecutive adult patients with cancer admitted to medical units at the MD Anderson Cancer Center, TX, during the 8-month preimplementation (May 1, 2019-December 31, 2019) and postimplementation period (May 1, 2020-December 31, 2020). The primary outcome was ICU mortality. Secondary outcomes included ICU length of stay, hospital mortality, and proportion\/timing of care plan documentation. Propensity score weighting was used to adjust for differences in potential covariates, including age, sex, cancer diagnosis, race\/ethnicity, and Sequential Organ Failure Assessment score. <\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p> This study involved 12,941 hospitalized patients with cancer (pre n = 6,977; post n = 5,964) including 1,365 ICU admissions (pre n = 727; post n = 638). After multicomponent goals-of-care program initiation, we observed a significant reduction in ICU mortality (28.2% v 21.9%; change \u22126.3%, 95% CI, \u22129.6 to \u22123.1; P = .0001). We also observed significant decreases in length of ICU stay (mean change \u22121.4 days, 95% CI, \u22122.0 to \u22120.7; P &lt; .0001) and in-hospital mortality (7% v 6.1%, mean change \u22120.9%, 95% CI, \u22121.5 to \u22120.3; P = .004). The proportion of hospitalized patients with an in-hospital do-not-resuscitate order increased significantly from 14.7% to 19.6% after implementation (odds ratio, 1.4; 95% CI, 1.3 to 1.5; P &lt; .0001), and do-not-resuscitate order was established earlier (mean difference \u22123.0 days, 95% CI, \u22123.9 to \u22122.1; P &lt; .0001). <\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p> This study showed improvement in hospital outcomes and care plan documentation after implementation of a system-wide, multicomponent goals-of-care intervention. <\/jats:p><\/jats:sec>","DOI":"10.1200\/jco.22.00849","type":"journal-article","created":{"date-parts":[[2022,10,6]],"date-time":"2022-10-06T19:59:23Z","timestamp":1665086363000},"page":"579-589","update-policy":"https:\/\/doi.org\/10.1200\/crossmark","source":"Crossref","is-referenced-by-count":20,"title":["Impact of an Interdisciplinary Goals-of-Care Program Among Medical Inpatients at a Comprehensive Cancer Center During the COVID-19 Pandemic: A Propensity Score Analysis"],"prefix":"10.1200","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2733-6607","authenticated-orcid":false,"given":"David","family":"Hui","sequence":"first","affiliation":[{"name":"Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3660-2762","authenticated-orcid":false,"given":"Nico","family":"Nortje","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX"},{"name":"Department of Dietetics and Nutrition, University of the Western Cape, Bellville, South 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