Improving Communication About Serious Illness (ICSI)
Principal Investigator:  JR Curtis
Research Contract:  Patient-Centered Outcomes Research Institute (PCORI), August 2013 to December 2016


This study is designed as a randomized trial of a communication feedback intervention designed to improve end-of-life communication and decision-making among physicians, nurses, families, and patients who have chronic, life-limiting illness.  The intervention will involve the use of feedback forms that will be created by surveying patients about their communication and treatment preferences.  The subsequent reports that are generated will be the feedback forms shared with the patient’s clinicians and family.

Our primary aim is to demonstrate to demonstrate the effectiveness of a communication intervention to improve end-of-life care for patients with chronic, life-limiting illness.  The outcomes we will measure include symptoms of anxiety in the context of receiving care for a life-limiting illness, symptoms of depression, quality of life, concordance between care that patients report they want and care they actually receive, and quality of communication about end-of-life care between patients, their clinicians, and their family members.  The second long term objective of this study is to demonstrate the feasibility of making this intervention a routine part of clinical care.

clinicaltrials.gov:  http://clinicaltrials.gov/show/NCT01933789

Publications from this study include:

Curtis JR, Downey L, Back AL, Nielsen EL, Paul S, Lahdya AZ, Treece PD, Armstrong P, Peck R, Engelberg RA. Effect of a Patient and Clinician Communication-Priming Intervention on Patient-Reported Goals-of-Care Discussions Between Patients With Serious Illness and Clinicians: A Randomized Clinical Trial. JAMA Intern Med. 2018 Jul 1;178(7):930-940.

Modes ME, Engelberg RA, Nielsen EL, Brumback LC, Neville TH, Walling AM, Curtis JR, Kross EK. Seriously Ill Patients’ Prioritized Goals and Their Clinicians’ Perceptions of Those Goals. J Pain Symptom Manage. 2022 Oct;64(4):410-418. Epub 2022 Jun 11.

Modes ME, Heckbert SR, Engelberg RA, Nielsen EL, Curtis JR, Kross EK. Patient-Reported Receipt of Goal-Concordant Care Among Seriously Ill Outpatients-Prevalence and Associated Factors. J Pain Symptom Manage. 2020 Oct;60(4):765-773. Epub 2020 May 7.

Modes ME, Engelberg RA, Downey L, Nielsen EL, Lee RY, Curtis JR, Kross EK. Toward Understanding the Relationship Between Prioritized Values and Preferences for Cardiopulmonary Resuscitation Among Seriously Ill Adults. J Pain Symptom Manage. 2019 Oct;58(4):567-577.e1. Epub 2019 Jun 19.

Modes ME, Engelberg RA, Downey L, Nielsen EL, Curtis JR, Kross EK. Did a Goals-of-Care Discussion Happen? Differences in the Occurrence of Goals-of-Care Discussions as Reported by Patients, Clinicians, and in the Electronic Health Record. J Pain Symptom Manage. 2019 Feb;57(2):251-259. Epub 2018 Nov 1.

Coats H, Downey L, Sharma RK, Curtis JR, Engelberg RA. Quality of Communication and Trust in Patients With Serious Illness: An Exploratory Study of the Relationships of Race/Ethnicity, Socioeconomic Status, and Religiosity. J Pain Symptom Manage. 2018 Oct;56(4):530-540.e6. Epub 2018 Jul 17.

Fakhri S, Engelberg RA, Downey L, Nielsen EL, Paul S, Lahdya AZ, Treece PD, Curtis JR. Factors Affecting Patients’ Preferences for and Actual Discussions About End-of-Life Care. J Pain Symptom Manage. 2016 Sep;52(3):386-94. Epub 2016 Jun 3.




Undergraduate Research Symposium — May 2017

Poster Session:  Improving Communication about Serious Illness
Presenter:  Tori Ly, Senior, Neurobiology;  Mary Gates Scholar, UW Honors Program
Mentors:  Ruth Engelberg, J. Randall Curtis, & Patsy Treece, Medicine, Harborview Medical Center