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Computers can help patients make decisions about end-of-life care

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End-of-life planning isn’t exactly fun -- especially when you are very sick and your days are probably numbered.

But researchers at Pennsylvania State College of Medicine and Pennsylvania State University are trying to make it easier with a computer program that helps patients think through difficult questions, such as whether they want aggressive treatment to prolong their lives or whether they’d rather maximize their quality of life, even if it means they’d probably die sooner.

The researchers tested their program with 20 patients who had moderate-to-severe chronic obstructive pulmonary disease (COPD), a lung condition that makes it difficult to breathe. The patients sat down with a computer and worked their way through the program. At the end, the program produced an advanced health care directive -- also known as a living will -- to convey to doctors what they would want in their final days.

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Overall, the patients were quite satisfied with those computer-generated advanced directives. On a scale of 1 to 10 (with 10 being the highest), the patients gave their living wills an average score of 8.5. They also liked the computer program itself, giving it an average rating of 8.6.

One concern about forcing patients to think about their end-of-life care is that it may make them pessimistic about their prospects for enjoying whatever time they have left. But the study found that using the computer program didn’t make patients less hopeful about their futures.

The research team has tested similar programs for patients with heart disease, cancer and amyotrophic lateral sclerosis (also known as ALS or Lou Gehrig’s disease) and found it helpful for people with those diseases, too.

The results with the COPD patients were presented Monday at the American Thoracic Society 2011 International Conference in Denver.

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