Measuring goal-concordant care using electronic clinical notes

Measuring goal-concordant care using electronic clinical notes
JAMA Network; by Catherine L. Auriemma, Anne Song, Lake Walsh, Jason Han, Sophia Yapalater, Alexander Bain, Lindsay Haines, Stefania Scott, Casey Whitman, Stephanie Parks Taylor, Gary E. Weissman, Matthew J. Gonzales, Roshanthi Weerasinghe, Staci J. Wendt, Katherine R. Courtright; 7/3/25
In this longitudinal cohort study among 109 patients with serious illness and limited prognoses, clinicians reviewed and classified 398 epochs of care as goal concordant (50%), goal discordant (19%), or of uncertain concordance (32%) with nearly perfect interrater agreement for categorizing the type of care received. These findings suggest that using electronic clinical notes to measure goal-concordant care is feasible, laying the groundwork for future automated text-based classification methods to improve reliability and pragmatism of measuring goal-concordant care for clinical and research use at scale.