SynthesisBMC palliative care2023
How does ethnicity affect presence of advance care planning in care records for individuals with advanced disease? A mixed-methods systematic review.
Synthesis in BMC palliative care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses 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, 2 syntheses or guidelines pooled it, 43 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
- Autism interventions designed or adapted for the Black/African American population: A systematic review.Autism : the international journal of research and practice · 2025Pooled it
- The Impact of Race and Physician-Patient Racial Concordance on the Incidence of Inpatient Advance Care Planning.Journal of general internal medicine · 2026Observational
- Anticipatory Advance Care Planning Visits and COVID-19 Treatment Intensity Among Medicare Fee-for-Service Beneficiaries: A Retrospective Observational Study.Journal of general internal medicine · 2026Observational
- Large language models perpetuate bias in palliative care: Development and analysis of the Palliative Care Adversarial Dataset (PCAD).PLOS digital health · 2026Article
- Supporting Advance Care Planning Among Mandarin and Cantonese Speaking Communities: A Qualitative Exploratory Study.Current oncology (Toronto, Ont.) · 2026Article
- Advance care planning uptake in the severely frail.BMC palliative care · 2026Observational
- Codesigning the iCanPlan Program to promote advance care planning among consumers from ethnic minority backgrounds in cancer care.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Advance Care Planning Motivators Among Adults With Serious Illness.JAMA network open · 2025Article
- Mechanical ventilation for young people with Duchenne muscular dystrophy: a factorial survey of the main influences on clinician decision-making.European journal of pediatrics · 2025Article
- Advance Care Planning in Multicultural Communities: A Document Analysis of Resources to Support Healthcare Staff and Consumers in Australia.Health expectations : an international journal of public participation in health care and health policy · 2025Article
- Patterns of Life-Sustaining Treatment Preferences Among Seriously Ill Veterans.Journal of the American Geriatrics Society · 2025Observational
- Multi Components in the Implementation of Advanced Care Planning for Patients with Cancer: A Scoping Review.Journal of caring sciences · 2025Review
- Linguistic factors and COVID-19 outcomes among long-term care residents in Ontario, Canada.BMC geriatrics · 2025Article
- Don't assume, ask! A focus group study on end-of-life care planning with people with intellectual disabilities from minoritised ethnic groups.BMC palliative care · 2025Article
- Co-production in practice: A qualitative study of the development of advance care planning workshops for South Asian elders.Palliative medicine · 2025Article
- Disparities in Advance Care Planning Across Rurality, Sociodemographic Characteristics, and Cognition Levels: Evidence from the Health and Retirement Study.Journal of ageing and longevity · 2024Article
- Racial disparities in the frequency and timing of code status orders among women with breast cancer.BMC cancer · 2024Article
- Achieving goal-concordant care: Formal and informal advance care planning for White, Black, and Hispanic older adults.Journal of the American Geriatrics Society · 2024Article
- Advance care planning as perceived by marginalized populations: Willing to engage and facing obstacles.PloS one · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAdvance care planning (ACP) is the process supporting individuals with life-limiting illness to make informed decisions about their future healthcare. Ethnic disparities in ACP have been widely highlighted, but interpretation is challenging due to methodological heterogeneity. This review aims to examine differences in the presence of documented ACP in individuals' care records for people with advanced disease by ethnic group, and identify patient and clinician related factors contributing to this.
methodsMixed-methods systematic review. Keyword searches on six electronic databases were conducted (01/2000-04/2022). The primary outcome measure was statistically significant differences in the presence of ACP in patients' care records by ethnicity: quantitative data was summarised and tabulated. The secondary outcome measures were patient and clinician-based factors affecting ACP. Data was analysed qualitatively through thematic analysis; themes were developed and presented in a narrative synthesis. Feedback on themes was gained from Patient and Public Involvement (PPI) representatives. Study quality was assessed through Joanna Briggs Institute Critical Appraisal tools and Gough's Weight of Evidence.
resultsN=35 papers were included in total; all had Medium/High Weight of Evidence. Fifteen papers (comparing two or more ethnic groups) addressed the primary outcome measure. Twelve of the fifteen papers reported White patients had statistically higher rates of formally documented ACP in their care records than patients from other ethnic groups. There were no significant differences in the presence of informal ACP between ethnic groups. Nineteen papers addressed the secondary outcome measure; thirteen discussed patient-based factors impacting ACP presence with four key themes: poor awareness and understanding of ACP; financial constraints; faith and religion; and family involvement. Eight papers discussed clinician-based factors with three key themes: poor clinician confidence around cultural values and ideals; exacerbation of institutional constraints; and pre-conceived ideas of patients' wishes.
conclusionsThis review found differences in the presence of legal ACP across ethnic groups despite similar presence of informal end of life conversations. Factors including low clinician confidence to deliver culturally sensitive, individualised conversations around ACP, and patients reasons for not wishing to engage in ACP (including, faith, religion or family preferences) may begin to explain some documented differences.
trial registrationPROSPERO-CRD42022315252.
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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.