Douglas White
University of Pittsburgh, PA·Medicine & Clinical Research·Early-career
When a patient in the intensive care unit cannot breathe on their own and is too sick to speak for themselves, decisions about how aggressively to treat fall to family members acting as surrogate decision-makers, guided by conversations with clinicians. Those conversations often go badly for patients: people with a poor prognosis frequently receive intensive, burdensome treatment near the end of life that does not match their own values.
- Fields
Medicine & Clinical Research
Public Health & Epidemiology
- Topics
acute respiratory failure
surrogate decision making
goal-concordant care
- Grants
- 1 known grant, through Jul 2029
What they work on
- Elicit from people with surrogate decision-making experience how clinicians should support surrogates of patients with acute respiratory failure in order to achieve care that matches patients' goals and values.
- Determine whether clinicians counsel surrogate decision-makers differently across patient groups, analyzing a large existing dataset of audio-recorded clinician-family conversations in intensive care units.
- Examine, in exploratory analyses, how communication patterns in goals-of-care conversations relate to patient-centeredness of care, family psychological distress, trust, and end-of-life health care utilization.
- Mentor clinician-scientists in patient-oriented research on interventions that promote goal-concordant care for incapacitated patients with advanced respiratory failure, with training in health disparities methodology and communication science.
More about the research
Care that matches a patient's goals, called goal-concordant care, is a basic element of ethical practice, and there is evidence that quality of serious-illness care differs across patient groups. What is not known is how much clinicians' own communication patterns contribute to those disparities.
Why it matters
More than 1.9 million people in the United States each year develop acute respiratory failure, and many are too ill to make their own treatment decisions. Identifying whether and how clinicians counsel families differently, and which conversation patterns track with family distress, trust, and end-of-life treatment intensity, could inform interventions that help patients receive care matching their values and reduce disparities in serious-illness care.
Known grants
From NIH and NSF research grants. Labs often have other funding we can't see.
Closest labs
Jacqueline Kruser
University of Wisconsin-Madison, WI·Medicine & Clinical Research
Map how time-limited trials of mechanical ventilation are actually carried out in five ICUs, using focused ethnography of 50 trials in patients with acute respiratory failure.
Grant Pignatiello
Case Western Reserve University, OH·Psychology
Test whether REFRAME, a tablet-based cognitive reappraisal program, reduces depressive symptoms in ICU surrogate decision-makers compared with informational support, in a 387-person randomized controlled trial.
Ravi Parikh
Emory University, GA·Medicine & Clinical Research
Test in a randomized trial whether A-PACT, machine learning risk prediction paired with lay health worker phone outreach, reduces hospitalizations and intensive end-of-life care for patients with cancer.
The school
University of Pittsburgh: 83 labs on PI Pages, $1.5B a year on research, 403 research doctorates a year.
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