Questioning Lay Health Worker Influence on Goals-of-Care Documentation and Patient Satisfaction—In Reply

In Reply We would like to thank Mssrs Yew Wei Heng and Anbarasan for their comment. We agree that educational attainment may be correlated with patients' comprehension of their health care preferences and satisfaction. However, educational attainment is unlikely to have confounded our estimates of the effect of the intervention on the study outcomes because participants were randomized between the intervention and the control arm. Like the other covariates we reported in the online supplemental table, we did not find differences in educational attainment across the intervention and control groups in our study. In both arms, approximately 20% of patients had less than a high school degree, 29% were high school graduates, 22% had finished some college, 18% had completed a bachelor's degree, and 11% had completed an advanced degree.

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