Research Projects
Current Projects
Our projects address interrelated problems of high public health significance, as supported by several decades of intensive care unit (ICU) research.
Why We Study Shared Decision-making in the Neuro-ICU
Shared decision-making is a collaborative process that allows patients, or their surrogates, and clinicians to make health care decisions together. This means considering the best scientific evidence available as well as the patient’s values, goals and preferences.
Severe Acute Brain Injury Is Common
Every 30 seconds, an adult in the U.S. has a neurological emergency (SABI) from traumatic brain injury or a large ischemic or hemorrhagic stroke, resulting in 200,000 deaths and nearly 900,000 survivors living with variable levels of disability annually.
Families Face Tough Decisions
Most deaths (about 80%) occur in the ICU after decisions by patients’ surrogate decision-makers to withdraw life-sustaining treatments, usually within two weeks after SABI. While family members grapple with their loved one’s unexpected illness, they rely on clinicians to offer an outlook (prognostication) to make high-stakes decisions about withdrawing or continuing life support.
Communications Break Down
Breakdowns in communication are common and result in decisions by families that may differ from what a patient would have chosen. Shared decision-making provides a critical opportunity to improve clinician-family communication and help ensure patients receive treatments they would choose.
Research Can Help
Interventions that increase the likelihood of decisions that align with patient values and preferences can have a major impact on patients and family members, as well as on clinicians and health care systems. Effective shared decision-making may reduce the psychological burden of surrogate decision-makers, decrease the time to make the decision and potentially lower associated costs.
