ArticleCancer2020
Barriers to the early integration of palliative care in pediatric oncology in 11 Eurasian countries.
Article in Cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 30 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 44 citations in OpenAlex.
- Determinants of delayed childhood cancer care in low- and middle-income countries: A systematic review.Pediatric blood & cancer · 2023Pooled it
- Nursing Perspectives on Palliative and Supportive Care in Paediatric Oncology: A Multicentre Qualitative Study.Nursing open · 2026Article
- Communication Barriers and Facilitators to Specialist Pediatric Palliative Care Involvement in Pediatric Oncology Settings Across Canada.Psycho-oncology · 2026Article
- Physician Perceptions Toward Palliative Care Integration in Childhood Cancer Care in Asia Pacific.JCO global oncology · 2026Article
- Integration of Pediatric Palliative Care in Oncology: A Scoping Review.Journal of pediatrics. Clinical practice · 2026Article
- Pediatric home-based hospice and palliative care: a scoping review.BMC palliative care · 2026Article
- Barriers to Palliative Care Integration for Children With Cancer Across Asia Pacific.JCO global oncology · 2026Article
- Translation and multi-site validation of the 'Pediatric Complex Care Needs Assessment Scale' (ACCAPED) from Italian to English.BMC palliative care · 2026Article
- Strategies to improve healthcare team communication structure and quality in resource-variable childhood cancer hospitals (TeamTalk): a study protocol.Implementation science communications · 2025Article
- Early Versus Late Pediatric Palliative Care in Oncology: A Systematic Review of Outcomes, Disparities, and Implementation Barriers : Palliative Care in Oncology.Galen medical journal · 2025Review
- Barriers and facilitators influencing referral and access to palliative care for children and young people with life-limiting and life-threatening conditions: a scoping review of the evidence.Palliative medicine · 2024Article
- Characterizing disparities in receipt of palliative care for Asian Americans, Native Hawaiians, and Pacific Islanders with metastatic cancer in the United States.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Paediatric oncologists' perspectives on Strategic solutions to develop Integrated Cancer Palliative Care: feedback intervention theory as an explanatory Framework.BMC palliative care · 2024Article
- Paediatric palliative care in cancer.Ecancermedicalscience · 2024Review
- Perceptions of physicians caring for pediatric patients with cancer in Europe: insights into the use of palliative care, its timing, and barriers to early integration.Frontiers in oncology · 2024Article
- Is it early enough? The authentic meaning of the pediatric palliative approach between early and late referral in pediatric oncology: a case study.Frontiers in oncology · 2024Article
- Palliative care services in paediatric oncology centres across Europe: A cross-sectional survey.EJC paediatric oncology · 2023Article
- Physician Perceptions of and Barriers to Pediatric Palliative Care for Children With Cancer in Brazil.JCO global oncology · 2023Article
- Article
- Ideal vs Actual Timing of Palliative Care Integration for Children With Cancer in Latin America.JAMA network open · 2023Article
Corrections and comments
- Erratum issued
Authors and funding
17 authors at 6 institutions in 5 countries.
Funding
Abstract
backgroundThe early integration of palliative care significantly improves quality of life for children with cancer. However, cultural, structural, and socioeconomic barriers can delay the integration of palliative care into cancer care, particularly in low-income and middle-income countries. To date, little is known regarding the timing of and barriers to palliative care integration in Eurasia.
methodsThe Assessing Doctors' Attitudes on Palliative Treatment (ADAPT) survey evaluates physician perceptions regarding palliative care integration into pediatric oncology in Eurasia. This evidence-based survey was adapted to the regional context; iteratively reviewed by US and regional panelists; and piloted in English, Russian, and Mongolian. After distribution to physicians caring for children with cancer, statistical analysis was complemented by qualitative analysis of open-ended responses.
resultsA total of 424 physician responses were received from 11 countries in the Eurasian region. Study findings demonstrated wide variability in access to palliative care experts across countries (18%-96%), with the majority of providers (64%) reporting that the initial palliative care consultation typically occurs when curative options are no longer available. Providers desired an earlier initial palliative care consultation than what currently occurs in their setting (P < .001). Primary barriers to timely consultation included limited access to palliative care services and specialists, lack of physician education, and perceived family resistance.
conclusionsThe current study is the first to identify physician perceptions of the delayed timing of palliative care integration into childhood cancer care and associated barriers in Eurasia. These findings will inform the development of targeted interventions to mitigate local structural and cultural barriers to access and facilitate earlier palliative care integration in the region.
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Registered trials
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.