Figure 2

Sensitivity Analyses of the utility of discharge to long-term ECF and of the utility of having a complication from intubation. Results of two way sensitivity analyses are illustrated as tables with increasing willingness to tradeoff time from life expectancy (LE) to avoid discharge to long-term ECF; and to avoid having complications from intubation. The shaded regions are utilities for which the recommended directive is DNI. Utilities have negative values (corresponding to states worse than death) if the patient is willing to tradeoff large amounts of time alive to avoid complications from intubation. The numbers in brackets represent the calculated utilities. Three separate figures correspond to the effect of preferences on the AD decision for different severities of baseline COPD. For patients with mild COPD (Figure 3a), DNI becomes the recommended directive only when the patient is willing to tradeoff more than 1 year of LE to avoid complications of intubation. For patients with moderate COPD (Figure 3c), DNI becomes the recommended directive when the patient is willing to tradeoff more than 6 months of LE to avoid complications of intubation. DNI also becomes the recommended directive when the patient is willing to tradeoff more than 1 year of LE to avoid long-term ECF. For patients with severe COPD (Figure 3c), DNI becomes the recommended directive when the patient is willing to tradeoff more than 1 month of LE to avoid complications of intubation. DNI also becomes the recommended directive when the patient is willing to tradeoff more than 2 months of LE to avoid long-term ECF. When taking both patient preferences into account, if the patient is willing to tradeoff more than 1 week of LE to avoid complications of intubation and discharge to long-term ECF, DNI becomes the recommended directive.