ReviewJournal of pain and symptom management2023
Don't Throw the Baby Out With the Bathwater: Meta-Analysis of Advance Care Planning and End-of-life Cancer Care.
Review in Journal of pain and symptom management, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 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
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 33 citations in OpenAlex.
- Evaluating outcomes of advance care planning interventions for adults living with advanced illness and people close to them: A systematic meta-review.Palliative medicine · 2025Pooled it
- Facilitated Versus Patient-Directed Advance Care Planning Among Patients With Advanced Cancer: A Randomized Clinical Trial.JCO oncology practice · 2025Trial
- Mindfulness to enhance quality of life and support advance care planning: a pilot randomized controlled trial for adults with advanced cancer and their family caregivers.BMC palliative care · 2024Trial
- Advance directives in Finnish long-term care: Do sociodemographic characteristics and regional factors matter?Scandinavian journal of public health · 2026Article
- Advance care planning uptake in the severely frail.BMC palliative care · 2026Observational
- Advanced cancer patients' knowledge and opinions regarding the French law on advance directives: a multicenter cross-sectional study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026Article
- Perceived self-efficacy on advance care planning in Latin America: ACP-SEs Latam validation.Frontiers in psychology · 2026Article
- [Changes in treatment goals and palliative care in the intensive care unit-when and how?]Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2025Review
- Breaking with the status quo in end-of-life care through de-implementation.Journal of internal medicine · 2025Review
- The 4Palliative & supportive care · 2025Article
- Instruments for Value Elucidation in Older Adults in Clinical Practice-A Scoping Review.Journal of the American Geriatrics Society · 2025Article
- Clinician attitudes toward palliative care to enhance the quality of life for patients with sickle cell disease.Journal of sickle cell disease · 2025Article
- Co-production in practice: A qualitative study of the development of advance care planning workshops for South Asian elders.Palliative medicine · 2025Article
- Article
- A Personalized and Interactive Web-Based Advance Care Planning Intervention for Older Adults (Koda Health): Pilot Feasibility Study.JMIR aging · 2024Article
- What Clinicians and Researchers Should Know About the Evolving Field of Advance Care Planning: a Narrative Review.Journal of general internal medicine · 2024Review
- Communicating with LGBTQ+ persons at end of life: A case-based analysis of interdisciplinary palliative clinician perspectives.Psycho-oncology · 2023Article
- Evaluating the pragmatic characteristics of advance care planning outcome measures in dementia clinical trials: A scoping review.Journal of the American Geriatrics Society · 2023Article
- Disparities in advance care planning among older US immigrants.Journal of the American Geriatrics Society · 2023Article
- Quality and Satisfaction With Advance Care Planning Conversations Among English- and Spanish-Speaking Older Adults.Journal of palliative medicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
contextThere is ongoing discourse about the impact of advance care planning (ACP) on end-of-life (EOL) care. No meta-analysis exists to clarify ACP's impact on patients with cancer.
objectiveTo investigate the association between, and moderators of, ACP and aggressive vs. comfort-focused EOL care outcomes among patients with cancer.
methodsFive databases were searched for peer-reviewed observational/experimental ACP-specific studies that were published between 1990-2022 that focused on samples of patients with cancer. Odds ratios were pooled to estimate overall effects using inverse variance weighting.
resultsOf 8,673 articles, 21 met criteria, representing 33,541 participants and 68 effect sizes (54 aggressive, 14 comfort-focused). ACP was associated with significantly lower odds of chemotherapy, intensive care, hospital admissions, hospice use fewer than seven days, hospital death, and aggressive care composite measures. ACP was associated with 1.51 times greater odds of do-not-resuscitate orders. Other outcomes-cardiopulmonary resuscitation, emergency department admissions, mechanical ventilation, and hospice use-were not impacted. Tests of moderation revealed that the communication components of ACP produced greater reductions in the odds of hospital admissions compared to other components of ACP (e.g., documents); and, observational studies, not experimental, produced greater odds of hospice use.
conclusionThis meta-analysis demonstrated mixed evidence of the association between ACP and EOL cancer care, where tests of moderation suggested that the communication components of ACP carry more weight in influencing outcomes. Further disease-specific efforts to clarify models and components of ACP that work and matter to patients and caregivers will advance the field.
Indexed as
Identifiers
What OpenQuestion holds
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.