Intuition vs. Deliberation in Medical Decision Making

• Sponsor: University of Pennsylvania (Other)
• Overall Status: Completed
• CT.gov ID: NCT02487810
• Collaborator: Leonard Davis Institute (Other)
• Enrollment: 200
• Location: 1
• Arms: 2
• Duration (Months): 8
• Patients Per Site Per Month: 24.9

Study Details

Study Description

Brief Summary

The purpose of this study is to determine whether there are systematic differences between the decisions patients make intuitively versus deliberatively about life-sustaining medical therapies.

The targeted population is inpatients at the Hospital of the University of Pennsylvania with serious medical problems. The study will involve facilitated interviews with patients using a survey instrument developed in Qualtrics.

Condition or Disease	Intervention/Treatment	Phase
Decision Making About Life-sustaining Treatment in Patients With Serious Cardiac, Respiratory and Oncological Conditions Likely to Limit Life Expectancy	Behavioral: Cognitive load; Behavioral: Deliberative instructions	N/A

Study Design

• Study Type: Interventional
• Actual Enrollment: 200 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Single (Participant)
• Primary Purpose: Other
• Official Title: Intuition Versus Deliberation in Decisions About Life-Sustaining Medical Therapies
• Study Start Date: Jul 1, 2015
• Actual Primary Completion Date: Mar 1, 2016
• Actual Study Completion Date: Mar 1, 2016

Arms and Interventions

Arm	Intervention/Treatment
Experimental: Intuitive Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding medical interventions. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions.	Behavioral: Cognitive load; Patients in the intuition arm of the study will be asked to complete a memorization task while they are answering survey questions.
Experimental: Deliberative Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding medical interventions. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions.	Behavioral: Deliberative instructions; Patients in the deliberative arm will be given instructions to take their time and deliberate on their decisions

Outcome Measures

Primary Outcome Measures

1. Acceptance or Refusal of a Feeding Tube for Chronic Aspiration [The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally]

   Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding acceptance of a feeding tube for chronic aspiration. In this hypothetical scenario, patients are presented with a situation in which they are unable to eat or drink safely such that small amounts of food or liquid go to their lungs and cause trouble with breathing. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions. Cognitive load: Patients in the intuition arm of the study will be asked to complete a memorization task while they are answering survey questions.

2. Acceptance or Refusal of Antibiotics [The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally]

   Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding acceptance of antibiotics. In this hypothetical scenario, patients are presented with an illness severity such that they drift in and out of consciousness some days and are expected to die in several months. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions. Cognitive load: Patients in the intuition arm of the study will be asked to complete a memorization task while they are answering survey questions.

3. Acceptance or Refusal of Breathing Machine [The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally]

   Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding acceptance of a breathing machine. In this hypothetical scenario, patients are presented with a life-threatening illness with 50% chance of survival provided that they receive support from a breathing machine for two weeks. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions. Cognitive load: Patients in the intuition arm of the study will be asked to complete a memorization task while they are answering survey questions.

4. Acceptance or Refusal of Tracheostomy [The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally]

   Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding acceptance of a tracheostomy and support from a breathing machine for at least two months to survive. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions. Cognitive load: Patients in the intuition arm of the study will be asked to complete a memorization task while they are answering survey questions.

Secondary Outcome Measures

1. Scores on Uncertainty Subscale of Decisional Conflict Scale [The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally]

   Decisional uncertainty will be evaluated using the uncertainty subscale of the Decisional Conflict Scale ranging from 0-100 such that 0 = extremely CERTAIN about best choice and 100 = extremely UNCERTAIN about the best choice. Higher values represent MORE UNCERTAINTY with decisions regarding feeding tubes, antibiotics, intubation, and tracheostomy while lower values represent LESS UNCERTAINTY.

2. Correlation Between Accepting Tracheostomy and Thinking That Being Bed Bound is Equal to or Worse Than Death [The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally]

   This outcome measures the proportion of participants who accept tracheostomy AND indicate that bed bound is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.

3. Correlation Between Accepting Antibiotics and Thinking That Being Bed Bound is Equal to or Worse Than Death. [The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally]

   This outcome measures the proportion of participants who accept antibiotics AND indicate that bed bound is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.

4. Correlation Between Accepting Tracheostomy and Thinking That Needing Care All the Time is Equal to or Worse Than Death [The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally]

   This outcome measures the proportion of participants who accept tracheostomy AND indicate that needing care all the time is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.

5. Correlation Between Accepting Antibiotics and Thinking That Needing Care All the Time is Equal to or Worse Than Death [The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally]

   This outcome measures the proportion of participants who accept antibiotics AND indicate that needing care all the time is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.

6. Correlation Between Accepting Tracheostomy and Thinking That Living in a Nursing Home is Equal to or Worse Than Death [The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally]

   This outcome measures the proportion of participants who accept tracheostomy AND indicate that living in a nursing home is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.

7. Correlation Between Accepting Antibiotics and Thinking That Living in a Nursing Home is Equal to or Worse Than Death [The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally]

   This outcome measures the proportion of participants who accept antibiotics AND indicate that living in a nursing home is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.

8. Correlation Between Accepting Tracheostomy and Thinking That Relying on a Breathing Machine is Equal to or Worse Than Death [The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally]

   This outcome measures the proportion of participants who accept tracheostomy AND indicate that relying on a breathing machine is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.

9. Correlation Between Accepting a Feeding Tube and Thinking That Relying on a Feeding Tube is Equal to or Worse Than Death [The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally]

   This outcome measures the proportion of participants who accept a feeding tube AND indicate that relying on a feeding tube is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.

Eligibility Criteria

Criteria

• Ages Eligible for Study: 60 Years and Older
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Inclusion Criteria:

1. Age 60 and older

2. Currently an inpatient at Hospital of the University of Pennsylvania

3. Speaks and reads fluently in English

4. Either

5. Has one of the following medical conditions:

• Chronic obstructive pulmonary disease with at least severe airflow obstruction on most recent spirometry and/or eligible for long-term oxygen therapy

• Incurable interstitial lung disease with at least severe restriction on most recent pulmonary function tests and/or eligible for long-term oxygen therapy

• Congestive heart failure with NYHA Class III or higher and current hospitalization related to heart failure

• Acute myeloid leukemia

• Stage IV lymphoma

• Stage IIIB or Stage IV non-small cell lung cancer, cholangiocarcinoma, renal cell carcinoma, breast cancer, uterine cancer, cervical cancer, ovarian cancer, colorectal cancer, gastric cancer, pancreatic cancer, prostate cancer, urothelial cancer

• Stage C or D hepatocellular carcinoma

• Mesothelioma or any malignancy metastatic to the pleura; or

1. Is hospitalized on oncology, pulmonary or cardiology service and has been hospitalized at least one other time during the last year on the same service

2. Stable vital signs

Exclusion Criteria:

1. Notation of code status limitation in electronic medical record

2. Cognitive impairment to the point unable to give informed consent

3. Current feeding tube placement

4. Current tracheostomy

5. Severe pain, shortness of breath or other uncontrolled symptoms

6. Actively undergoing evaluation for solid organ transplant

7. First hospitalization after diagnosis of serious illness

Contacts and Locations

Locations

	Site	City	State	Country	Postal Code
1	Hospital of the University of Pennsylvania	Philadelphia	Pennsylvania	United States	19104

Sponsors and Collaborators

• University of Pennsylvania
• Leonard Davis Institute

Investigators

• Principal Investigator: Scott D Halpern, MD, PhD, University of Pennsylvania

Study Documents (Full-Text)

None provided.

More Information

Publications

None provided.

• Responsible Party: Scott Halpern, Assistant Professor of Medicine, University of Pennsylvania
• ClinicalTrials.gov Identifier: NCT02487810
• Other Study ID Numbers: UPenn 822238
• First Posted: Jul 2, 2015
• Last Update Posted: Jul 19, 2019
• Last Verified: May 1, 2019

Study Results

Participant Flow

Arm/Group Title	Intuitive	Deliberative
Arm/Group Description	Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding medical interventions. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions. Cognitive load: Patients in the intuition arm of the study will be asked to complete a memorization task while they are answering survey questions.	Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding medical interventions. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions. Deliberative instructions: Patients in the deliberative arm will be given instructions to take their time and deliberate on their decisions
Period Title: Overall Study
STARTED	98	102
COMPLETED	97	102
NOT COMPLETED	1	0

Baseline Characteristics

Arm/Group Title	Intuitive	Deliberative	Total
Arm/Group Description	Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding medical interventions. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions. Cognitive load: Patients in the intuition arm of the study will be asked to complete a memorization task while they are answering survey questions.	Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding medical interventions. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions. Deliberative instructions: Patients in the deliberative arm will be given instructions to take their time and deliberate on their decisions	Total of all reporting groups
Overall Participants	97	102	199
Age (years) [Mean (Standard Deviation) ]
Mean (Standard Deviation) [years]	66.5 (4.8)	67.9 (5.2)	67.2 (5.0)
Sex: Female, Male (Count of Participants)
Female	33 34%	34 33.3%	67 33.7%
Male	64 66%	68 66.7%	132 66.3%

Outcome Measures

1. Primary Outcome

Title	Acceptance or Refusal of a Feeding Tube for Chronic Aspiration
Description	Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding acceptance of a feeding tube for chronic aspiration. In this hypothetical scenario, patients are presented with a situation in which they are unable to eat or drink safely such that small amounts of food or liquid go to their lungs and cause trouble with breathing. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions. Cognitive load: Patients in the intuition arm of the study will be asked to complete a memorization task while they are answering survey questions.
Time Frame	The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intuitive Arm	Deliberative Arm
Arm/Group Description
Measure Participants	97	102
Accept Feeding Tube	41 42.3%	45 44.1%
Reject Feeding Tube	56 57.7%	57 55.9%

2. Primary Outcome

Title	Acceptance or Refusal of Antibiotics
Description	Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding acceptance of antibiotics. In this hypothetical scenario, patients are presented with an illness severity such that they drift in and out of consciousness some days and are expected to die in several months. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions. Cognitive load: Patients in the intuition arm of the study will be asked to complete a memorization task while they are answering survey questions.
Time Frame	The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intuitive Arm	Deliberative Arm
Arm/Group Description
Measure Participants	97	102
Accept antibiotics	38 39.2%	44 43.1%
Refuse antibiotics	59 60.8%	58 56.9%

3. Primary Outcome

Title	Acceptance or Refusal of Breathing Machine
Description	Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding acceptance of a breathing machine. In this hypothetical scenario, patients are presented with a life-threatening illness with 50% chance of survival provided that they receive support from a breathing machine for two weeks. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions. Cognitive load: Patients in the intuition arm of the study will be asked to complete a memorization task while they are answering survey questions.
Time Frame	The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intuitive Arm	Deliberative Arm
Arm/Group Description
Measure Participants	97	102
Accept intubation	57 58.8%	61 59.8%
Refuse intubation	40 41.2%	41 40.2%

4. Primary Outcome

Title	Acceptance or Refusal of Tracheostomy
Description	Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding acceptance of a tracheostomy and support from a breathing machine for at least two months to survive. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions. Cognitive load: Patients in the intuition arm of the study will be asked to complete a memorization task while they are answering survey questions.
Time Frame	The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intuitive Arm	Deliberative Arm
Arm/Group Description
Measure Participants	97	102
Accept tracheostomy	36 37.1%	42 41.2%
Refuse tracheostomy	61 62.9%	60 58.8%

5. Secondary Outcome

Title	Scores on Uncertainty Subscale of Decisional Conflict Scale
Description	Decisional uncertainty will be evaluated using the uncertainty subscale of the Decisional Conflict Scale ranging from 0-100 such that 0 = extremely CERTAIN about best choice and 100 = extremely UNCERTAIN about the best choice. Higher values represent MORE UNCERTAINTY with decisions regarding feeding tubes, antibiotics, intubation, and tracheostomy while lower values represent LESS UNCERTAINTY.
Time Frame	The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intuitive Arm	Deliberative Arm
Arm/Group Description
Measure Participants	97	102
Feeding Tube	21.5 (23.1)	20.9 (21.1)
Antibiotics	20.3 (21.7)	18.9 (21.2)
Intubation	26.2 (25.5)	20.8 (22.1)
Tracheostomy	29.4 (25.3)	23.6 (24.8)

6. Secondary Outcome

Title	Correlation Between Accepting Tracheostomy and Thinking That Being Bed Bound is Equal to or Worse Than Death
Description	This outcome measures the proportion of participants who accept tracheostomy AND indicate that bed bound is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.
Time Frame	The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intuitive Arm	Deliberative Arm
Arm/Group Description
Measure Participants	26	37
Accept tracheostomy	4 4.1%	9 8.8%
Refuse tracheostomy	22 22.7%	28 27.5%

7. Secondary Outcome

Title	Correlation Between Accepting Antibiotics and Thinking That Being Bed Bound is Equal to or Worse Than Death.
Description	This outcome measures the proportion of participants who accept antibiotics AND indicate that bed bound is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.
Time Frame	The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intuitive Arm	Deliberative Arm
Arm/Group Description
Measure Participants	26	37
Accept Antibiotics	6 6.2%	13 12.7%
Refuse Antibiotics	20 20.6%	24 23.5%

8. Secondary Outcome

Title	Correlation Between Accepting Tracheostomy and Thinking That Needing Care All the Time is Equal to or Worse Than Death
Description	This outcome measures the proportion of participants who accept tracheostomy AND indicate that needing care all the time is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.
Time Frame	The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intuitive Arm	Deliberative Arm
Arm/Group Description
Measure Participants	21	25
Accept Tracheostomy	2 2.1%	8 7.8%
Refuse Tracheostomy	19 19.6%	17 16.7%

9. Secondary Outcome

Title	Correlation Between Accepting Antibiotics and Thinking That Needing Care All the Time is Equal to or Worse Than Death
Description	This outcome measures the proportion of participants who accept antibiotics AND indicate that needing care all the time is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.
Time Frame	The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intuitive Arm	Deliberative Arm
Arm/Group Description
Measure Participants	21	25
Accept Antibiotics	4 4.1%	9 8.8%
Refuse Antibiotics	17 17.5%	16 15.7%

10. Secondary Outcome

Title	Correlation Between Accepting Tracheostomy and Thinking That Living in a Nursing Home is Equal to or Worse Than Death
Description	This outcome measures the proportion of participants who accept tracheostomy AND indicate that living in a nursing home is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.
Time Frame	The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intuitive Arm	Deliberative Arm
Arm/Group Description
Measure Participants	18	26
Accept Tracheostomy	4 4.1%	5 4.9%
Refuse Tracheostomy	14 14.4%	21 20.6%

11. Secondary Outcome

Title	Correlation Between Accepting Antibiotics and Thinking That Living in a Nursing Home is Equal to or Worse Than Death
Description	This outcome measures the proportion of participants who accept antibiotics AND indicate that living in a nursing home is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.
Time Frame	The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intuitive Arm	Deliberative Arm
Arm/Group Description
Measure Participants	18	26
Accept Antibiotics	5 5.2%	8 7.8%
Refuse Antibiotics	13 13.4%	18 17.6%

12. Secondary Outcome

Title	Correlation Between Accepting Tracheostomy and Thinking That Relying on a Breathing Machine is Equal to or Worse Than Death
Description	This outcome measures the proportion of participants who accept tracheostomy AND indicate that relying on a breathing machine is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.
Time Frame	The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intuitive Arm	Deliberative Arm
Arm/Group Description
Measure Participants	25	32
Accept Tracheostomy	4 4.1%	7 6.9%
Refuse Tracheostomy	21 21.6%	25 24.5%

13. Secondary Outcome

Title	Correlation Between Accepting a Feeding Tube and Thinking That Relying on a Feeding Tube is Equal to or Worse Than Death
Description	This outcome measures the proportion of participants who accept a feeding tube AND indicate that relying on a feeding tube is a state that is either equal to, or worse than death. This proportion will be measured separately in the deliberative and intuitive groups; these proportions will then be compared.
Time Frame	The trial involves a questionnaire that will be given on a single day; patients will not be followed longitudinally

Outcome Measure Data

Analysis Population Description

[Not Specified]

Arm/Group Title	Intuitive Arm	Deliberative Arm
Arm/Group Description
Measure Participants	46	54
Accept feeding tube	7 7.2%	16 15.7%
Refuse feeding tube	39 40.2%	38 37.3%

Adverse Events

Adverse Event Reporting Description	This is a minimal risk study. We did not monitor for serious adverse events because 0 participants were at risk.
Arm/Group Title	Intuitive		Deliberative
Arm/Group Description	Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding medical interventions. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions. Cognitive load: Patients in the intuition arm of the study will be asked to complete a memorization task while they are answering survey questions.		Patients in each arm will be asked all of the same questions. The only difference between the arms will be the instructions regarding how and when to answer the series of hypothetical questions regarding medical interventions. The instructions will be designed to influence patients to think either intuitively or deliberatively about the questions regarding life-sustaining interventions. Deliberative instructions: Patients in the deliberative arm will be given instructions to take their time and deliberate on their decisions
All Cause Mortality
	Intuitive		Deliberative
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	/ (NaN)		/ (NaN)
Serious Adverse Events
	Intuitive		Deliberative
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/0 (NaN)		0/0 (NaN)
Other (Not Including Serious) Adverse Events
	Intuitive		Deliberative
	Affected / at Risk (%)	# Events	Affected / at Risk (%)	# Events
Total	0/97 (0%)		0/102 (0%)

Limitations/Caveats

[Not Specified]

More Information

Certain Agreements

Principal Investigators are NOT employed by the organization sponsoring the study.

There is NOT an agreement between Principal Investigators and the Sponsor (or its agents) that restricts the PI's rights to discuss or publish trial results after the trial is completed.