August 2020 – Time-limited trials of therapy are a powerful tool when the benefit/burden balance of treatment is uncertain.
This approach has many benefits.
– It names the elephant in the room: uncertainty.
– It helps patients/families and providers think about goals of care, acceptable trade-offs, and how to define success.
– It buys time to allow a case to develop AND sets a specific time to re-evaluate progress.
Time-limited trials can be applied to any difficult decisions, including dialysis, ventilation, artificial feeding, and inpatient rehabilitation. We even have time-limited trials of hospice care!