title: [Assessment of a tool for decision making in case of worsening condition of cancer patients].
abstract: BACKGROUND
  In response to questions regarding the appropriate intensity of care for some patients, "a decision support aid regarding the intensity of care in case of worsening condition of a patient with a chronic disease" has been established at the Grenoble university hospital. According to patient's wishes and the experience of the medical and paramedical team who are responsible for him, a level of intensity of care will be suggested.
  
  
  METHODS
  We propose a prospective and multicenter study conducted in the Rhône-Alpes-Auvergne area. All lung cancer patients admitted to a pulmonology unit in 2014 would be included. This document would be used if a decision to withhold life-sustaining treatment exists. We would assess the relationship between the planned intensity of care and those established when the patient develops organ failure. Patient characteristics and factors associated with proposed levels and types of care would be analyzed. Patient and family opinions will be obtained at 3 months. The number of subjects to be included is 468.
  
  
  RESULTS
  Therefore, we hope to be able to define the wishes of patients' and to propose an appropriate and adapted aid for decisions if they develop organ failure.
authors.affiliation: UM oncologie thoracique, pôle cancérologie médecine aiguë et communautaire, centre hospitalier universitaire A.-Michallon, BP 217, 38043 Grenoble cedex 9, France; Université Grenoble 1 U 823, 38042 Grenoble cedex 9, France. Electronic address: AToffart@chu-grenoble.fr.
authors.forename: A-C
authors.initials: AC
authors.lastname: Toffart
authors.affiliation: UM oncologie thoracique, pôle cancérologie médecine aiguë et communautaire, centre hospitalier universitaire A.-Michallon, BP 217, 38043 Grenoble cedex 9, France.
authors.forename: L
authors.initials: L
authors.lastname: Sakhri
authors.affiliation: Service de pneumologie, hôpital Louis-Pradel, hospices civils de Lyon, 69577 Bron cedex, France.
authors.forename: N
authors.initials: N
authors.lastname: Girard
authors.affiliation: Service de pneumologie et oncologie thoracique, centre hospitalier Lyon Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France; Faculté de médecine Lyon Sud-Charles-Mérieux, université Claude-Bernard Lyon 1, 165, chemin du Petit-Revoyet, 69921 Oullins cedex, France.
authors.forename: S
authors.initials: S
authors.lastname: Couraud
authors.affiliation: Service de pneumologie - oncologie thoracique, centre hospitalier universitaire G.-Montpied, 63003 Clermont-Ferrand cedex 1, France.
authors.forename: P
authors.initials: P
authors.lastname: Merle
authors.affiliation: Département d'oncologie médicale, institut de cancérologie Lucien-Neuwirth, 42270 Saint-Priest-en-Jarez, France.
authors.forename: P
authors.initials: P
authors.lastname: Fournel
authors.affiliation: Service de cancérologie médicale, centre Léon-Berard, 69008 Lyon, France.
authors.forename: M
authors.initials: M
authors.lastname: Perol
authors.affiliation: Service de pneumologie et oncologie thoracique, centre hospitalier Lyon Sud, hospices civils de Lyon, 165, chemin du Grand-Revoyet, 69495 Pierre-Bénite cedex, France; Faculté de médecine Lyon Sud-Charles-Mérieux, université Claude-Bernard Lyon 1, 165, chemin du Petit-Revoyet, 69921 Oullins cedex, France.
authors.forename: P-J
authors.initials: PJ
authors.lastname: Souquet
authors.affiliation: IAME, UMR 1137, université Paris Diderot Sorbonne Paris Cité, 75205 Paris cedex 13, France; Service de réanimation, hôpital Bichat, AP-HP, 75018 Paris, France.
authors.forename: J-F
authors.initials: JF
authors.lastname: Timsit
authors.affiliation: UM oncologie thoracique, pôle cancérologie médecine aiguë et communautaire, centre hospitalier universitaire A.-Michallon, BP 217, 38043 Grenoble cedex 9, France; Université Grenoble 1 U 823, 38042 Grenoble cedex 9, France.
authors.forename: D
authors.initials: D
authors.lastname: Moro-Sibilot
mesh_terms: D003661:Decision Support Techniques; D018450:Disease Progression; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications / Q000523:psychology; D008297:Male; D009102:Multiple Organ Failure / Q000209:etiology; D010361:Patients / Q000523:psychology; D011368:Professional-Family Relations; D011369:Professional-Patient Relations; D011446:Prospective Studies; D012107:Research Design; D028761:Withholding Treatment / Q000941:ethics
keywords: Cancer bronchique; Décision thérapeutique; Défaillance d’organe; End of life; Fin de vie; Intensive care unit; Lung neoplasm; Organ failure; Réanimation; Therapeutic decision