Algorithm-enabled Goals of Care Communication
Starting soon · Not applicable
Conditions studied: Cancer
In brief
In 2017, the VA launched the Life-Sustaining Treatment Decisions Initiative (LSTDI), a national program to promote Goals of Care communication between clinicians and patients regarding goals and preferences for care. Despite clinician training and standardized Life Sustaining Treatment (LST) notes in the electronic health record (EHR), 60% of Veterans with cancer have not engaged in such communication with their oncology clinicians before death. Over the past 10 years, the team developed and tested: 1) a lay health worker-led intervention to improve these conversations and reduce unwanted, intensive end-of-life care, and 2) an algorithm-driven approach to identify patients in need of urgent conversations with their clinical teams. This randomized study will evaluate the effectiveness of an intervention combining these two approaches across 7 VA oncology sites. The outcomes include LST documentation, Veteran-reported anxiety and depression, and the identification of factors to inform broad scale of Veteran-centric interventions to improve GoC communication.
Key facts
- Study ID
- NCT07690904
- Run by
- VA Office of Research and Development
- People needed
- 200
- Starts
- 2026-09-15
- Expected to finish
- 2031-06-30
- Last updated by the study team
- 2026-07-29
Who can join
Age: 18 and older. Sex: any. Healthy volunteers: not accepted.
You may qualify if…
- Veteran patients with diagnosis of a solid malignancy with any cancer stage
- English or Spanish-speaking
- Can self-administer questionnaires in English or Spanish
- Valid telephone number
- Receiving oncology care at one of 7 sites
- Receiving systemic anti-cancer therapy, defined as oral, injection, or intravenous therapy
- chemotherapy
- hormone therapy
- targeted therapy
- or immunotherapy defined by the National Cancer Institute A to Z List of Cancer Drugs)
- CAN risk score ≥98th percentile (may be adjusted after examining site-level CAN performance)
You may not qualify if…
- No capacity to consent
- Actively receiving hospice care
Where it is running
- VA Palo Alto Health Care System, Palo Alto, CA — Palo Alto, California, United States
Full record on ClinicalTrials.gov
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