PC Trials at State of Science: Tom LeBlanc, Kate Courtright, & Corita Grudzen
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
39 min
4 speakers
5 chapters
transcribed 9 hours ago
Transcript
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Transcript generated automatically by AI and may contain errors.
What is the overall focus of this State of the Science episode?
Welcome to the Jerry Powell podcast. This is Eric Quadera.
This is Alex Smith.
Alex, who do we have with us today? We are at AHBA A I can't eighty
eighty Was it a long night last night? Were you at the Jerry Powell pub crawl? I may have been at the Jerry Powell Praw. What time did you get home, young man? Two thirty AM.
Actually that's the way we ended. Yeah. Yeah. Um Alex, who's with us today at the end we're delighting
HBM meeting. We have Corita Gridsen. Is that right? Oh damn. Grudson. Corina Grudson, who is an emergency medicine physician and she's at Memorial Sloan Kettering. She's a researcher and we're gonna hear more about her research soon. And we have Kate Cortwright, who's at the University of Pennsylvania, the Payer Center. They study palliative care. She's pulmonary critical care and palliative medicine trained. And we have Tom LeBlanc, who's from Duke. Who is also palliative care trained and an oncologist? Welcome, Karita and Kate and
Tom. Thank you. Thank you. So we got a lot to cover today. We're gonna be covering kind of what you're gonna be presenting at the State of the Science tomorrow. So this is pre recorded. But before we do that. We uh we have a song request from
No, we don't. They failed to give me a song request. Therefore they're being punished. And they have to sing along to my cheesy choice of feel like making science. Feel like making science singing by bad company. And everybody's gonna sing, including Ann Kelly, who's filming us over there. Ann, you wanna say hi?
I'm
Here we go. Let's see how this goes. Here we go.
Baby. When I think about you Think about some Ah yes. Darling Don't live without you. And your side. If I Those golden green. My silence. I would rap the In the heaven. Yeah. Feel like making I'm making Be like making Like making science.
Oh, that was great.
Song request will always be honored in the future.
Lesson learned. Okay, we got we got three trials to talk about. These are like big trials in palliative care and And kind of is no s is there a similar theme here? I'm not let's just jump into the trials. Kate, I'm gonna start with you.
Okay.
In your trial. Okay. Baby Hall economics trial, right? Yes. Why did you decide to do this trial?
Um, because we have a problem in the ICU with communication.
What's that problem?
Uh the problem is we communicate late. We uh share prognosis late, we um elicit goals and values late. And so all the time while they're in the ICU getting prolonged intensive care, we don't really know that we're providing goal concordant care. Uh-huh. So we wanted to nudge it a little upstream. Nudges. Nudge it.
Nudges. Behavioral economics. We've certainly talked about that before. We have. Alex makes fun of me because I bring up that podcast every single podcast. Um real quickly for our audience, what's a nudge?
Um, so a nudge in its simplest form is really any change to choice architecture. Um oops, sorry. Um, or like a choice frame in which you are trying to overcome inherent human decision making biases to guide people gently towards um a desired choice that is in theirs or others' best interest. And it neither restricts nor incentivizes choice.
So that really expensive surf and turf meal that I saw on the menu last night. Probably not a lot of people ordered really cheap one. It's gonna nudge me towards one of those middle items.
Well that yep, that's fine. Yep. Expanded choice sets, you know, move that's a marketing technique. Yep.
Okay.
Mm-hmm.
So what did you do in the trial?
Um in the trial we uh tested two nudges. One was um called a focusing effect. So we all, when bombarded with information, sort of have to take certain elements of a decision and focus on those. And in the ICU you can imagine we're bombarded with information a lot. And so what we did was um ask clinicians um earlier in the ICU stay for very sick patients to document prognosis and for those who they thought would survive to document six month functional prognosis. And that helped them focus on that instead of, say, the blood pressure, the vasopressors or the ventilator settings that day.
And how did you do that?
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Chapters
5 chapters
1
What is the overall focus of this State of the Science episode?
0:01–9:37
2
Why did Kate Courtright design a pragmatic ICU nudge trial?
9:37–14:06
3
How do behavioral‑economics nudges work in the ICU setting?
14:06–17:17
4
What were the key methods and eligibility criteria of the ICU nudge trial?
17:17–28:28
5
Did the ICU nudges improve length of stay, hospice use, or other outcomes?
28:28–39:39
Speakers
4 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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