***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: ABSTRACT BACKGROUND Decisions about cardiopulmonary resuscitation ( CPR ) and intubation are a core part of advance care planning , particularly for seriously ill hospitalized patients . However , these discussion s are often avoided . OBJECTIVES We aim ed to examine the impact of a video decision tool for CPR and intubation on patients ’ choices , knowledge , medical orders , and discussion s with providers . DESIGN This was a prospect i ve r and omized trial conducted between 9 March 2011 and 1 June 2013 on the internal medicine services at two hospitals in Boston . PARTICIPANTS One hundred and fifty seriously ill hospitalized patients over the age of 60 with an advanced illness and a prognosis of 1 year or less were included . Mean age was 76 and 51 % were women . INTERVENTIONThree-minute video describing CPR and intubation plus verbal communication of participants ’ preferences to their physicians ( intervention ) ( N = 75 ) or control arm ( usual care ) ( N = 75).MAIN MEASURES The primary outcome was participants ’ preferences for CPR and intubation ( immediately after viewing the video in the intervention arm ) . Secondary outcomes included : orders to withhold CPR/intubation , documented discussion s with providers during hospitalization , and participants ’ knowledge of CPR/ intubation ( five-item test , range 0–5 , higher scores indicate greater knowledge ) . RESULTS Intervention participants ( vs. controls ) were more likely not to want CPR ( 64 % vs. 32 % , p < 0.0001 ) and intubation ( 72 % vs. 43 % , p < 0.0001 ) . Intervention participants ( vs. controls ) were also more likely to have orders to withhold CPR ( 57 % vs. 19 % , p < 0.0001 ) and intubation ( 64 % vs.19 % , p < 0.0001 ) by hospital discharge , documented discussion s about their preferences ( 81 % vs. 43 % , p < 0.0001 ) , and higher mean knowledge scores ( 4.11 vs. 2.45 ; p < 0.0001 ) . CONCLUSIONS Seriously ill patients who viewed a video about CPR and intubation were more likely not to want these treatments , be better informed about their options , have orders to forgo CPR/ intubation , and discuss preferences with providers . Trial registration : Clinical trials.gov NCT01325519 Registry Name : A prospect i ve r and omized trial using video images in advance care planning in seriously ill hospitalized patients Background Previous studies have demonstrated that video of and scripted information about cardiopulmonary resuscitation ( CPR ) can be deployed during clinician – patient end-of-life discussion s. Few studies , however , examine whether video adds to verbal information-sharing . We hypothesized that video augments script-only decision-making . Methods Patients aged > 65 years admitted to hospital wards were r and omized to receive evidence -based information ( “ script ” ) vs. script plus video of simulated CPR and intubation . Patients ’ decisions registered in the hospital record , by hospital discharge were compared for the two groups . Results Fifty script-only intervention patients averaging 77.7 years were compared to 50 script+video patients with a mean age of 74.7 years . Eleven of 50 ( 22 % ) in each group declined CPR ; and an additional three ( script ) vs. four ( script+video )  refused intubation for respiratory failure . There were no differences in sex , self-reported health trajectory , functional limitations , length of stay , or mortality associated with decisions . Conclusion The rate at which verbally informed hospitalized elders opted out of resuscitation was not impacted by adding a video depiction of CPR BACKGROUND : Patient preferences regarding cardiopulmonary resuscitation ( CPR ) are important , especially during hospitalization when a patient 's health is changing . Yet many patients are not adequately informed or involved in the decision‐making process . OBJECTIVES : We examined the effect of an informational video about CPR on hospitalized patients ' code status choices . DESIGN : This was a prospect i ve , r and omized trial conducted at the Minneapolis Veterans Affairs Health Care System in Minnesota . PARTICIPANTS : We enrolled 119 patients , hospitalized on the general medicine service , and at least 65 years old . The majority were men ( 97 % ) with a mean age of 75 . INTERVENTION : A video described code status choices : full code ( CPR and intubation if required ) , do not resuscitate ( DNR ) , and do not resuscitate/do not intubate ( DNR/DNI ) . Participants were r and omized to watch the video ( n = 59 ) or usual care ( n = 60 ) . MEASUREMENTS : The primary outcome was participants ' code status preferences . Secondary outcomes included a question naire design ed to evaluate participants ' trust in their healthcare team and knowledge and perceptions about CPR . RESULTS : Participants who viewed the video were less likely to choose full code ( 37 % ) compared to participants in the usual care group ( 71 % ) and more likely to choose DNR/DNI ( 56 % in the video group vs. 17 % in the control group ) ( P < 0.00001 ) . We did not see a difference in trust in their healthcare team or knowledge and perceptions about CPR as assessed by our question naire . CONCLUSIONS : Hospitalized patients who watched a video about CPR and code status choices were less likely to choose full code and more likely to choose DNR/DNI PURPOSE Decision making regarding cardiopulmonary resuscitation ( CPR ) is challenging . This study examined the effect of a video decision support tool on CPR preferences among patients with advanced cancer . PATIENTS AND METHODS We performed a r and omized controlled trial of 150 patients with advanced cancer from four oncology centers . Participants in the control arm ( n = 80 ) listened to a verbal narrative describing CPR and the likelihood of successful resuscitation . Participants in the intervention arm ( n = 70 ) listened to the identical narrative and viewed a 3-minute video depicting a patient on a ventilator and CPR being performed on a simulated patient . The primary outcome was participants ' preference for or against CPR  measured immediately after exposure to either modality . Secondary outcomes were participants ' knowledge of CPR ( score range of 0 to 4 , with higher score indicating more knowledge ) and comfort with video . RESULTS The mean age of participants was 62 years ( st and ard deviation , 11 years ) ; 49 % were women , 44 % were African American or Latino , and 47 % had lung or colon cancer . After the verbal narrative , in the control arm , 38 participants ( 48 % ) wanted CPR , 41 ( 51 % ) wanted no CPR , and one ( 1 % ) was uncertain . In contrast , in the intervention arm , 14 participants ( 20 % ) wanted CPR , 55 ( 79 % ) wanted no CPR , and 1 ( 1 % ) was uncertain ( unadjusted odds ratio , 3.5 ; 95 % CI , 1.7 to 7.2 ; P < .001 ) . Mean knowledge scores were higher in the intervention arm than in the control arm ( 3.3 ± 1.0 v 2.6 ± 1.3 , respectively ; P < .001 ) , and 65 participants ( 93 % ) in the intervention arm were comfortable watching the video . CONCLUSION Participants with advanced cancer who viewed a video of CPR were less likely to opt for CPR than those who listened to a verbal narrative Objective : To determine the relationship of electrocardiographic rhythm during cardiac arrest with survival outcomes . Design : Prospect i ve , observational study . Setting : Total of 411 hospitals in the National Registry of Cardiopulmonary Resuscitation . Patients : Total of 51,919 adult patients with pulseless cardiac arrests from April 1999 to July 2005 . Measurements and Main Results : Registry data collected included first documented rhythm , patient demographics , pre-event data , event data , and survival and neurologic outcome data . Of 51,919 indexed cardiac arrests , first documented pulseless rhythm was ventricular tachycardia ( VT ) in 3810 ( 7 % ) , ventricular fibrillation ( VF ) in 8718 ( 17 % ) , pulseless electrical activity ( PEA ) in 19,262 ( 37 % ) and asystole 20,129 ( 39 % ) . Subsequent VT/VF ( that is , VT or VF occurring during resuscitation for PEA or asystole ) occurred in 5154 ( 27 % ) , with first documented rhythm of PEA and 4988 ( 25 % ) with asystole . Survival to hospital discharge rate was not different between those with first documented VF and VT ( 37 % each , adjusted odds ratio [ OR ] ) 1.08 ; 95 % confidence interval [ CI ] 0.95–1.23 ) . Survival to hospital discharge was slightly more likely after PEA than asystole ( 12 % vs. 11 % , adjusted OR 1.1 ; 95 % CI 1.00–1.18 ) , Survival to discharge was substantially more likely after first documented VT/VF than PEA/asystole ( adjusted OR 1.68 ; 95 % CI 1.55–1.82 ) . Survival to discharge was also more likely after PEA/asystole without subsequent VT/VF compared with PEA/asystole with subsequent VT/VF ( 14 % vs. 7 % for PEA without vs. with subsequent VT/VF ; 12 % vs. 8 % for asystole without vs. with subsequent VT/VF ; adjusted OR 1.60 ; 95 % CI , 1.44–1.80 ) . Conclusions : Survival to hospital discharge was substantially more likely when the first documented rhythm was shockable rather than nonshockable , and slightly more likely after PEA than asystole . Survival to hospital discharge was less likely following PEA/asystole with subsequent VT/VF compared to PEA/asystole without subsequent VT/VF Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more PURPOSE To determine whether the use of a goals -of-care video to supplement a verbal description can improve end-of-life decision making for patients with cancer . METHODS Fifty participants with malignant glioma were r and omly assigned to either a verbal narrative of goals -of-care options at the end of life ( control ) , or a video after the same verbal narrative ( intervention ) in this r and omized controlled trial . The video depicts three levels of medical care : life-prolonging care ( cardiopulmonary resuscitation [ CPR ] , ventilation ) , basic care ( hospitalization , no CPR ) , and comfort care ( symptom relief ) . The primary study outcome was participants ' preferences for end-of-life care . The secondary outcome was participants ' uncertainty regarding decision making ( score range , 3 to 15 ; higher score indicating less uncertainty ) . Participants ' comfort level with the video was also measured . RESULTS Fifty participants were r and omly assigned to either the verbal narrative ( n = 27 ) or video ( n = 23 ) . After the verbal description , 25.9 % of participants preferred life-prolonging care , 51.9 % basic care , and 22.2 % comfort care . In the video arm , no participants preferred life-prolonging care , 4.4 % preferred basic care , 91.3 % preferred comfort care , and 4.4 % were uncertain ( P < .0001 ) . The mean uncertainty score was higher in the video group than in the verbal group ( 13.7 v 11.5 , respectively ; P < .002 ) . In the intervention arm , 82.6 % of participants reported being very comfortable watching the video . CONCLUSION Compared with participants who only heard a verbal description , participants who viewed a goals -of-care video were more likely to prefer comfort care and avoid CPR , and were more certain of their end-of-life decision making . Participants reported feeling comfortable watching the video BACKGROUND  Cardiopulmonary resuscitation ( CPR ) is an important advance directive ( AD ) topic in patients with progressive cancer ; however such discussion s are challenging . OBJECTIVE This study investigates whether video educational information about CPR engenders broader advance care planning ( ACP ) discourse . METHODS Patients with progressive pancreas or hepatobiliary cancer were r and omized to an educational CPR video or a similar CPR narrative . The primary end-point was the difference in ACP documentation one month posttest between arms . Secondary end-points included study impressions ; pre- and post-intervention knowledge of and preferences for CPR and mechanical ventilation ; and longitudinal patient outcomes . RESULTS Fifty-six subjects were consented and analyzed . Rates of ACP documentation ( either formal ADs or documented discussion s ) were 40 % in the video arm ( 12/30 ) compared to 15 % in the narrative arm ( 4/26 ) , OR=3.6 [ 95 % CI : 0.9 - 18.0 ] , p=0.07 . Post-intervention knowledge was higher in both arms . Posttest , preferences for CPR had changed in the video arm but not in the narrative arm . Preferences regarding mechanical ventilation did not change in either arm . The majority of subjects in both arms reported the information as helpful and comfortable to discuss , and they recommended it to others . More deaths occurred in the video arm compared to the narrative arm , and more subjects died in hospice setting s in the video arm . CONCLUS 
    Output:
    
Conclusions and Relevance Communication interventions are associated with patient decisions regarding do-not-resuscitate code status and better patient knowledge and may thus improve code status discussion