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Time-limited trials. We\\u2019ve all probably used them before. We meet with patients and families.\\xa0 We agree to either start or continue a particular treatment to see if it helps in some specific way over some defined period of time. If it works as hoped, great, we continue the treatments.\\xa0 If not, we stop them.\\xa0 At least that is how it\\u2019s supposed to go.\\xa0

On today\\u2019s podcast we talk all about these time-limited trials with Dong Chang and Ricky Leiter.\\xa0 Dong was the lead author of a JAMA IM article looking at the outcomes of training staff to use time-limited trials as the default communication and care planning approach for critically ill patients in intensive care units. \\xa0 Ricky is the lead author of the accompanying editorial and palliative care physician extraordinaire.\\xa0\\xa0\\xa0

We discussed with Dong and Ricky about the results of the JAMA IM study, which were pretty darn impressive.\\xa0 The intervention resulted in significant reductions in duration of ICU stay (7.4 v 8.7 days), fewer invasive procedures, but no change in mortality, and no change in family satisfaction rating (which was high before and after the intervention).\\xa0 We discuss potential reasons why the intervention worked, some limitations of the study, the role uncertainty plays in decision-making, and so much more (including nudging from our last podcast).\\xa0

If you want to read more about time-limited trials, check out these articles as well:\\xa0

• Paula Spans NY Times article on Time limited trials titled \\u201cI need to know I tried\\u201d\\xa0
• The JAMA IM study and editorial on time-limited trials
• Tim Quill and Robert Holloways article in JAMA on Time-Limited Trials from 2011
• And lastly our nudging podcast that we brought up several times

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