title: Perspectives on anticipated quality-of-life and recommendations for neonatal intensive care: a survey of neonatal providers.
abstract: OBJECTIVE
  Explore associations between neonatal providers' perspectives on survival, quality of life (QOL) and treatment recommendations.
  
  
  METHODS
  Providers attending a workshop on neonatal viability were surveyed about survival, perceived QOL and treatment recommendations for marginally viable infants. We assessed associations between estimated survival and perceived QOL and treatment recommendations.
  
  
  RESULTS
  In the 44 included surveys, estimates of survival and QOL varied widely. Maximum care was recommended 80% of the time when anticipated QOL was high, versus 20% when anticipated QOL was low (p < 0.001). Adjusted for confounders, odds of recommending maximum intervention were 4.4 times higher when anticipated QOL was high (95% CI 1.9 - 10.2, p = 0.001).
  
  
  CONCLUSIONS
  The perspectives of practitioners who provide care to critically ill neonates regarding potential survival and QOL vary dramatically and are associated with the treatments those practitioners recommend. Practitioners should take care to avoid basing treatment recommendations on their own perspectives if they are not well aligned with those of the parents.
authors.affiliation: a Department of Obstetrics , Gynecology, and Reproductive Sciences, University of California , San Francisco , CA .
authors.forename: Kirsten
authors.initials: K
authors.lastname: Salmeen
authors.forename: Annie
authors.initials: A
authors.lastname: Janvier
authors.forename: Sadath A
authors.initials: SA
authors.lastname: Sayeed
authors.forename: Eleanor A
authors.initials: EA
authors.lastname: Drey
authors.forename: John
authors.initials: J
authors.lastname: Lantos
authors.forename: J Colin
authors.initials: JC
authors.lastname: Partridge
mesh_terms: D000328:Adult; D016638:Critical Illness / Q000401:mortality / Q000628:therapy*; D006282:Health Personnel; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000401:mortality / Q000628:therapy*; D015931:Intensive Care, Neonatal; D008875:Middle Aged; D010290:Parents; D011788:Quality of Life; D011795:Surveys and Questionnaires
keywords: Congenital anomalies; extreme prematurity; quality of life; resuscitation; viability