Use of the Electronic Medical Record to Screen Code Status Preference Using Death Language (CODE-EMRS)

February 5, 2026 updated by: Karthik Joshua Kota, MD MPH, Rutgers, The State University of New Jersey

Choice of Diction's Effect: Electronic Measures of Resuscitation Status Inpatient

In order to systematically improve code status communication and documentation while clarifying how providers understand code status decisions, we propose the Choice of Diction's Effect Electronic Measures of Resuscitation Study Inpatient (CODE-EMRS.I) with 3 aims: Aim 1 - Determine rate of patient utilization of code status invitation (research) via the Portal (Hypothesis 1: Participants with an existing Portal are more likely to participate in research than new signups); Aim 2 - Evaluate different phrasings in code status prompts with and without death language (Hypothesis 2: Participants are more likely to pick no code with death language than without); Aim 3 - Determine how objective data drives physician agreement on code status decision (Hypothesis 3: Physicians are more likely to disagree with full code decisions for poor GO-FAR, but not CCI). Participants will fill out all study questionnaires electronically, but have options within these to ask to speak to a study physician/their own physician for clarification. After completing the surveys, the research associate will deliver the patient's code status decision to the attending of record and ask their views on it. Once a week, participants who have expressed interest in the study (by clicking the "I am interested" button) but have not completed the study will receive a reminder to complete the study as well as an offer to withdraw from the study in that same communication.

Study Overview

Status

Recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Estimated)

118

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

  • United States
    • New Jersey
      • New Brunswick, New Jersey, United States, 08901
        • Recruiting
        • Robert Wood Johnson University Hospital - New Brunswick
        • Contact:

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Older Adult

Accepts Healthy Volunteers

Yes

Description

Inclusion Criteria:

  • Age >65, English-fluency in reading and speaking, and the capacity to consent

Exclusion Criteria:

  • Requiring ICU-level care

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Experimental/Death language

Participants will be asked:

The purpose of this trial is to understand how the words we use to describe CPR affect patient decisions. Cardiopulmonary resuscitation (CPR) is performed when the heart stops beating. It consists of electric shocks to the heart, pumping the chest to circulate blood, and using a breathing machine to help with breathing. The success rate of CPR is about 1 in 7, and even when the heart restarts, the brain and other organs can be damaged. If your heart were to stop beating and you were to die without resuscitation, would you prefer that we attempt cardiopulmonary resuscitation (CPR), or would you prefer that we do not resuscitate (DNR)?
Behavioral: Death language
We will explicitly mention death when letting the participant know about CPR
No Intervention: Standard/non-death language

Participants will be asked:

The purpose of this trial is to understand how the words we use to describe CPR affect patient decisions. Cardiopulmonary resuscitation (CPR) is performed when the heart stops beating. It consists of electric shocks to the heart, pumping the chest to circulate blood, and using a breathing machine to help with breathing. The success rate of CPR is about 1 in 7, and even when the heart restarts, the brain and other organs can be damaged. If your heart were to stop beating, would you prefer that we attempt cardiopulmonary resuscitation (CPR), or would you prefer that we do not resuscitate (DNR)?

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Time Frame
Code status decision
Time Frame: At enrollment
At enrollment
Physician of record decision for and agreement with code status
Time Frame: Within 24 hours of patient decision
Within 24 hours of patient decision

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Rutgers, The State University of New Jersey

Investigators

  • Principal Investigator: Karthik J Kota, MD MPH, Assistant Professor of Medicine

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

February 9, 2026

Primary Completion (Estimated)

June 30, 2027

Study Completion (Estimated)

June 30, 2027

Study Registration Dates

First Submitted

February 5, 2026

First Submitted That Met QC Criteria

February 5, 2026

First Posted (Actual)

February 12, 2026

Study Record Updates

Last Update Posted (Actual)

February 12, 2026

Last Update Submitted That Met QC Criteria

February 5, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • Pro2025000307

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

De-identified individual participant data will be made available upon request to the Department of Medicine and approval of the data elements by appropriate regulatory elements in the Department

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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