Evidence map›Paper›PMID 30369600›Full record

Trial reportBritish journal of cancer2018

A randomised controlled trial of an advance care planning intervention for patients with incurable cancer.

Stephanie B Johnson, Phyllis N Butow, Melanie L Bell, Karen Detering, Josephine M Clayton, William Silvester, Belinda E Kiely, Stephen Clarke, Lisa Vaccaro, Martin R Stockler and 3 more

Open access · hybridAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in British journal of cancer, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 1 pooled it
6.7field-weighted citation impact, top 3% of its field
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

31 citing papers in PubMed, 1 synthesis or guideline pooled it, 76 citations in OpenAlex.

  1. Pooled it
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  5. Estimating survival in advanced cancer: a comparison of estimates made by oncologists and patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2020
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  20. Measuring Goal-Concordant Care in Palliative Care Research.Journal of pain and symptom management · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 6 institutions in 2 countries.

Stephanie B JohnsonCentre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology and Department of Medicine, University of Sydney, Sydney, NSW, Australia. Stephanie.johnson@sydney.edu.au.
Phyllis N ButowCentre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology and Department of Medicine, University of Sydney, Sydney, NSW, Australia.
Melanie L BellMel & Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, USA.
Karen DeteringAdvance Care Planning Department, Austin Hospital, Melbourne, Australia.
Josephine M ClaytonHammondCare Palliative and Supportive Care Service, Greenwich Hospital and Northern Clinical School, Kolling Institute of Medical Research, University of Sydney, Sydney, NSW, Australia.
William SilvesterUniversity of Melbourne, Melbourne, Australia.
Belinda E KielyNational Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia.
Stephen ClarkeDepartment of Medical Oncology, Northern Clinical School, Royal North Shore Hospital Sydney, Kolling Institute of Medical Research, Sydney, Australia.
Lisa VaccaroCentre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology and Department of Medicine, University of Sydney, Sydney, NSW, Australia.
Martin R StocklerNational Health and Medical Research Council Clinical Trials Centre, University of Sydney, Sydney, Australia.
Phillip BealeMedical Oncology, Sydney Local Health District (SLHD), Royal Prince Alfred Hospital (RPA), Sydney, NSW, Australia.
Natalie FitzgeraldAdvance Care Planning Department, Austin Hospital, Melbourne, Australia.
Martin H N TattersallCentre for Medical Psychology and Evidence-based Decision-making (CeMPED), School of Psychology and Department of Medicine, University of Sydney, Sydney, NSW, Australia.
University of Sydney · AUAustin Hospital · AURoyal North Shore Hospital · AURoyal Prince Alfred Hospital · AUUniversity of Arizona · USUniversity of Melbourne · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe modified and evaluated an advance care planning (ACP) intervention, which had been shown to improve compliance with patient's end of life (EoL) wishes, in a different patient population.

methodsPatients with incurable cancer, and a Family Member (FM), were randomised one-to-one to usual care or usual care plus an ACP intervention, between April 2014 and January 2017. Oncologists and participants were non-blinded. ACP was based on the Respecting Patient Choices model, with an offer to provide individualised ranges for typical, best-case and worst-case scenarios for survival time. Seven facilitators (two oncology nurses, two nurses and three allied health professionals) delivered the intervention within 2 weeks of study enrolment. The primary outcome measure, assessed by interviewing the FM 3 months after patient death, was the FM perception that the patient's wishes were discussed, and met.

resultsSix hundred and sixty-five patients from seven Australian metropolitan oncology centres were referred for consideration by their oncologists, 444 (67%) met the study inclusion criteria and were approached by a study researcher. Two hundred and eight patients (47%) and their FM entered the trial as dyads. Fifty-three (46%) dyads in the ACP group and 63 (54%) dyads in the usual-care group had complete primary outcome data (p = 0.16). Seventy-nine patients and 53 FMs attended an ACP discussion. Mean length of discussion was 57 min. FMs from 23 (43%) dyads allocated to ACP and 21 (33%) dyads allocated usual care reported the patient's EoL wishes were discussed and met (difference 10%, 95% CI: -2 to 8, p = 0.27). There were no differences in EoL care received, patient satisfaction with care; FM satisfaction with care or with death; or FM well being. Rates of palliative care referral were high in both groups (97% vs 96%).

conclusionsA formal ACP intervention did not increase the likelihood that EoL care was consistent with patients' preferences.

Indexed as

Advance Care PlanningPatient ParticipationTerminally IllAdultAged, 80 and overAustraliaCaregiversFamilyFemaleHumansMaleMiddle AgedNeoplasmsPatient SatisfactionProspective Studies

Identifiers

PMID30369600
PMCPMC6251033
OpenAlexW2896136721

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.