A new age for advance care planning and serious illness conversations in oncology

Extract

“Advance care planning is a process that supports adults at any age or stage of health in understanding and sharing their personal values, life goals, and preferences regarding future medical care. The goal of advance care planning is to help ensure that people receive medical care that is consistent with their values, goals, and preferences during serious and chronic illnesses.”¹

Although there has been controversy over whether advance care planning has merit, there is agreement that conversations with patients are critical to eliciting a patient’s goals, values, and priorities and ultimately aligning their preferences with care delivery, especially at the end of life.^2,3 There are many challenges in this space. Two key challenges in oncology are (1) prognosticating in an era with increasingly targeted and impactful therapies like Chimeric Antigen Receptor (CAR) T-Cell Therapy and (2) prioritizing these often lengthy conversations in busy clinics.^4-6 In this issue of the Journal, Gensheimer et al. sought to tackle this challenge by leveraging machine learning to assist with prognostication and scaling the impact of the limited oncology workforce by enabling care coaches to have robust serious illness conversations.⁷