ArticleJournal of pain and symptom management2020
Racial and Ethnic Differences in Communication and Care for Children With Advanced Cancer.
Article in Journal of pain and symptom management, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 2 of them syntheses that pooled it.
What it found
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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.
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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.
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Who cites it
18 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Current status of and factors influencing advance care planning participation among adolescents and young adults with cancer: a mixed-methods systematic review.BMC palliative care · 2026Pooled it
- Racial and ethnic disparities in communication study enrollment for young people with cancer: A descriptive analysis of the literature.Patient education and counseling · 2022Pooled it
- Bibliometric analysis of oncology communication from 1976 to 2025: a focus on narrative medicine.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Review
- Planting seeds for seasons ahead: Communication strategies for prognostic disclosure in pediatric neuro-oncology.Neuro-oncology practice · 2026Article
- Relationship Between Social Determinants of Health and Domains of Care Addressed During Pediatric Palliative Care Visits for Children with Cancer.Children (Basel, Switzerland) · 2025Article
- Bias and Disparities in Neonatal End-of-Life Care.NeoReviews · 2025Article
- The Hospitalisation Experience and Distress Among Jewish and Bedouin Parents of Hospitalised Children in Israel.Acta paediatrica (Oslo, Norway : 1992) · 2025Article
- Multicenter Study of Associations Between Area-Level Child Opportunity, Initial Disease Severity, and Outcomes Among Children with Lupus.Arthritis care & research · 2025Article
- Questions to promote child-centered care in racially discordant interactions in pediatric oncology.Patient education and counseling · 2024Article
- Trends in mortality from gastrointestinal, hepatic, and pancreatic cancers in the United States: A comprehensive analysis (1999-2020).JGH open : an open access journal of gastroenterology and hepatology · 2024Article
- Barriers to Pediatric Palliative Care: Trainee and Faculty Perspectives Across Two Academic Centers.Journal of palliative medicine · 2023Article
- Evaluation of a protocol for eliciting narrative accounts of pediatric inpatient experiences of care.Health services research · 2023Article
- The Day One Talk, 20 Years Later: What Have We Learned?JCO oncology practice · 2023Article
- Palliative Care in Pediatric Oncology and Hematopoietic Stem Cell Transplantation.Current oncology reports · 2022Review
- Relationship of race and ethnicity on access, timing, and disparities in pediatric palliative care for children with cancer.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2022Article
- Parent and Clinician Perspectives on Challenging Parent-Clinician Relationships in Pediatric Oncology.JAMA network open · 2021Article
- In the name of the family? Against parents' refusal to disclose prognostic information to children.Medicine, health care, and philosophy · 2021Article
- Polysymptomatology in Pediatric Patients Receiving Palliative Care Based on Parent-Reported Data.JAMA network open · 2021Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
contextRacial and ethnic disparities in end-of-life care are well documented among adults with advanced cancer.
objectivesTo examine the extent to which communication and care differ by race and ethnicity among children with advanced cancer.
methodsWe conducted a prospective cohort study at nine pediatric cancer centers enrolling 95 parents (42% racial/ethnic minorities) of children with poor prognosis cancer (relapsed/refractory high-risk neuroblastoma). Parents were surveyed about whether prognosis was discussed; likelihood of cure; intent of current treatment; and primary goal of care. Medical records were used to identify high-intensity medical care since the most recent recurrence. Logistic regression evaluated differences between white non-Hispanic and minority (black, Hispanic, and Asian/other race) parents.
resultsAbout 26% of parents recognized the child's low likelihood of cure. Minority parents were less likely to recognize the poor prognosis (odds ratio [OR] = 0.19; 95% CI = 0.06-0.63; P = 0.006) and the fact that current treatment was unlikely to offer cure (OR = 0.07; 95% CI = 0.02-0.27; P < 0.0001). Children of minority parents were more likely to experience high-intensity medical care (OR = 3.01; 95% CI = 1.29-7.02; P = 0.01). After adjustment for understanding of prognosis, race/ethnicity was no longer associated with high-intensity medical care (adjusted odds ratio = 2.14; 95% CI = 0.84-5.46; P = 0.11), although power to detect an association was limited.
conclusionParental understanding of prognosis is limited across racial and ethnic groups; racial and ethnic minorities are disproportionately affected. Perhaps as a result, minority children experience higher rates of high-intensity medical care. Work to improve prognostic understanding should include focused work to meet needs of minority populations.
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