Evidence map›Paper›PMID 18544726›Full record

ArticleJAMA2008

The role of chemotherapy at the end of life: "when is enough, enough?".

Sarah Elizabeth Harrington, Thomas J Smith

Abstract readCase Reports
PubMed Full text at PMC Publisher
In one paragraph

Article in JAMA, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 102 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
102citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

102 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Senior adult oncology.Journal of the National Comprehensive Cancer Network : JNCCN · 2012
    Guideline
  5. Trial
  6. Trial
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  8. Determinants of quality of life in patients with advanced cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2011
    Trial
  9. Trial
  10. Article
  11. Article
  12. Article
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  14. Article
  15. Cost of ovarian cancer by the phase of care in the United States.American journal of obstetrics and gynecology · 2025
    Article
  16. Article
  17. Article
  18. Observational
  19. [Chemotherapy at the end of life is compatible with dignified death and palliative care]Revista de la Facultad de Ciencias Medicas (Cordoba, Argentina) · 2023
    Article
  20. Article

42 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors.

Sarah Elizabeth HarringtonDepartment of Internal Medicine and the Thomas Palliative Care Program, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA 23298, USA.
Thomas J Smith

Funding

Palliative Care for Hospitalized Cancer PatientsR01CA116227 · NCI · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI MEIER, DIANE E · 2006 to 2010
$6.6M
Truthful Information about Prognosis and Options for People with Advanced CancerG08LM009525 · NLM · VIRGINIA COMMONWEALTH UNIVERSITY · PI SMITH, THOMAS JOSEPH · 2007 to 2008
$267k
NCI NIH HHS R01 CA116227NCI NIH HHS R01CA116227-01NLM NIH HHS 1G08LM009525-01NLM NIH HHS G08 LM009525
6 · The paper itself

Abstract

Patients face difficult decisions about chemotherapy near the end of life. Such treatment might prolong survival or reduce symptoms but cause adverse effects, prevent the patient from engaging in meaningful life review and preparing for death, and preclude entry into hospice. Palliative care and oncology clinicians should be logical partners in caring for patients with serious cancers for which symptom control, medically appropriate goal setting, and communication are paramount, but some studies have shown limited cooperation. We illustrate how clinicians involved in palliative care and oncology can more effectively work together with the story of Mr L, a previously healthy 56-year-old man, who wanted to survive his lung cancer at all costs. He lived 14 months with 3 types of chemotherapy, received chemotherapy just 6 days before his death, and resisted entering hospice until his prognosis and options were explicitly communicated. Approaches to communication about prognosis and treatment options and questions that patients may want to ask are discussed.

Indexed as

Interprofessional RelationsMedical OncologyPalliative CarePatient Acceptance of Health CarePhysician-Patient RelationsAntineoplastic AgentsAttitude to DeathDecision MakingHospicesHumansLung NeoplasmsMaleMiddle AgedPrognosisTerminally IllAntineoplastic Agents

Identifiers

PMID18544726
PMCPMC3099412

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.