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January 4, 2012

Time-Limited Trials—Reply

Author Affiliations

Author Affiliations: Center for Ethics, Humanities, and Palliative Care, University of Rochester Medical Center, Rochester, New York (timothy_quill@urmc.rochester.edu).

JAMA. 2012;307(1):33-34. doi:10.1001/jama.2011.1955

In Reply: Although our Commentary focused exclusively on TLTs toward the very end of life, we agree with Drs Abernethy and Currow that the concept has much broader applicability. In fact, virtually all interventions with uncertain clinical effects on outcomes could be framed in these terms, in which the probability of success, markers of response, and associated time frames would be presented and agreed upon upfront (eg, nearly all palliative chemotherapy regimens, biological treatments for autoimmune disorders, and all major invasive interventions such as mechanical ventilation, renal dialysis, or feeding tubes).

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