SynthesisFrontiers in oncology2023
Why is advance care planning underused in oncology settings? A systematic overview of reviews to identify the benefits, barriers, enablers, and interventions to improve uptake.
Synthesis in Frontiers in oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 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
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 19 citations in OpenAlex.
- Parental experiences in pediatric advance care planning for children with life-limiting illnesses: a qualitative meta-synthesis.BMC palliative care · 2026Pooled it
- Oncology physicians' and nurses' perspectives on barriers to advanced care planning for patients with cancer in Oman: A cross-sectional study.International journal of nursing sciences · 2026Article
- Advance care planning in the last year of life of patients with advanced cancer: patients' perspectives on decision-making and their family and physicians' awareness of future care preferences.Journal of cancer survivorship : research and practice · 2026Article
- Supporting Advance Care Planning Among Mandarin and Cantonese Speaking Communities: A Qualitative Exploratory Study.Current oncology (Toronto, Ont.) · 2026Article
- Advance care planning knowledge, attitudes, and experiences among hospital healthcare professionals: A survey.Palliative & supportive care · 2026Article
- Understanding Advance Care Planning in oncology: Barriers, perceptions, and pathways toward patient-centered decision-making.Palliative & supportive care · 2026Article
- 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
- From inferring preferences to enabling choice: potentials of digital tools to improve substitute decision-making.Frontiers in digital health · 2026Article
- Timely integration of palliative care into oncology in hospitals in the Netherlands: a feasibility study.BMC health services research · 2025Article
- Casemanagers Positioned as Key Advance Care Planning Conversationalists in Oncology Care: A Qualitative Interview Study on the Perspectives of Healthcare Professionals and Patients.Cancer medicine · 2025Article
- Advance care planning for adults with cancer.The Cochrane database of systematic reviews · 2025Article
- Proactive end-of-life conversations in residential care homes: a qualitative interview study exploring residents' and family members' experiences.BMC geriatrics · 2025Article
- Patients' Experiences With Advance Care Planning and Decision-Making: An Interview Study in Finnish Hospital Palliative Care Wards.Nursing open · 2025Article
- Mapping provider and consumer voices using the AACTT framework: a focus group study of advance care planning.BMC health services research · 2025Article
- Co-production in practice: A qualitative study of the development of advance care planning workshops for South Asian elders.Palliative medicine · 2025Article
- Summary of evidence to facilitate the implementation of advance care planning among advanced cancer patients.Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2024Article
- Theoretical Domains Framework: A Bibliometric and Visualization Analysis from 2005-2023.Journal of multidisciplinary healthcare · 2024Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Advance care planning (ACP) centres on supporting people to define and discuss their individual goals and preferences for future medical care, and to record and review these as appropriate. Despite recommendations from guidelines, rates of documentation for people with cancer are considerably low. Aim: To systematically clarify and consolidate the evidence base of ACP in cancer care by exploring how it is defined; identifying benefits, and known barriers and enablers across patient, clinical and healthcare services levels; as well as interventions that improve advance care planning and are their effectiveness. Methods: A systematic overview of reviews was conducted and was prospectively registered on PROSPERO. PubMed, Medline, PsycInfo, CINAHL, and EMBASE were searched for review related to ACP in cancer. Content analysis and narrative synthesis were used for data analysis. The Theoretical Domains Framework (TDF) was used to code barriers and enablers of ACP as well as the implied barriers targeted by each of the interventions. Results: Eighteen reviews met the inclusion criteria. Definitions were inconsistent across reviews that defined ACP (n=16). Proposed benefits identified in 15/18 reviews were rarely empirically supported. Interventions reported in seven reviews tended to target the patient, even though more barriers were associated with healthcare providers (n=40 versus n=60, respectively). Conclusion: To improve ACP uptake in oncology settings; the definition should include key categories that clarify the utility and benefits. Interventions need to target healthcare providers and empirically identified barriers to be most effective in improving uptake. Systematic review registration: https://www.crd.york.ac.uk/prospero/display_record.php?, identifier CRD42021288825.
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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.