Evidence map›Paper›PMID 40779038›Full record

Observational studySupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer2025

End-of-life discussions, preference concordance, and good death: insights from a nationwide mortality follow-back survey.

Yoko Nakazawa, Mitsunori Miyashita, Tatsuya Morita, Yoshiyuki Kizawa, Yasuyuki Okumura, Shohei Kawagoe, Hiroshi Yamamoto, Emi Takeuchi, Risa Yamazaki, Asao Ogawa

Abstract readObservational Study
PubMed Publisher
In one paragraph

Observational study in Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Yoko NakazawaDivision of Policy Evaluation, Institute for Cancer Control, National Cancer Center, 5-1-1 Tsukiji, Chuo-Ku, Tokyo, 104-0045, Japan. ynakazaw@ncc.go.jp.ORCID http://orcid.org/0000-0003-3658-4514
Mitsunori MiyashitaDepartment of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Tatsuya MoritaDepartment of Palliative and Supportive Care, Palliative Care Team, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan.
Yoshiyuki KizawaDepartment of Palliative and Supportive Care, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Yasuyuki OkumuraInitiative for Clinical Epidemiological Research, Machida, Tokyo, Japan.
Shohei KawagoeAozora Clinic, Matsudo, Chiba, Japan.
Hiroshi YamamotoDepartment of Respiratory, MedicineTokyo Metropolitan Institute for Geriatrics and Gerontology, Itabashi-Ku, Tokyo, Japan.
Emi TakeuchiDivision of Quality Assurance Programs, Institute for Cancer Control, National Cancer Center, Chuo-Ku, Tokyo, Japan.
Risa YamazakiDepartment of Medical Psychology, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan.
Asao OgawaDivision of Psycho-Oncology, Exploratory Oncology Research and Clinical Trial Center, National Cancer Center, Kashiwa, Chiba, Japan.

Funding

Ministry of Health, Labour and Welfare, Japan 22EA2001
6 · The paper itself

Abstract

purposeEnd-of-life (EOL) discussions are integral to EOL care. However, whether EOL discussions improve the concordance between care preferences and care received, and their association with a good death, remains uncertain. This study aimed to examine the association among EOL discussions, concordance with patient preferences for EOL care, and family-reported good deaths in patients with cancer.

methodsThis observational study analyzed 42,379 responses from national mortality follow-back survey targeting bereaved families of patients. Measurements included EOL discussions regarding resuscitation preferences (i.e., code status) and care settings, advance directives (ADs), concordance between patient preferences and received care, and family-reported good-death scores.

resultsEOL discussions between patients and physicians increased the concordance for resuscitation preferences and care settings. Concordance for do-not-attempt resuscitation (DNAR) order increased (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.46-2.06), as did full code (OR, 2.75; 95% CI, 2.03-3.74). Regarding care settings, preferred home care showed the highest concordance (OR, 4.60; 95% CI, 4.31-4.90). ADs were associated with concordance for full code preferences (OR, 1.63; 95% CI, 1.17-2.28) but not for DNAR. Preference concordance was associated with higher family-reported "good death" scores, with the largest difference observed for home care (71.4 vs. 60.2; difference, 11.2; 95% CI, 10.9-11.5).

conclusionEOL discussions enhanced preference-concordant care for resuscitation preferences and care settings, which were associated with better family-reported good deaths. These findings underscore the importance of integrating EOL discussions into routine oncology care to ensure high-quality EOL care that is consistent with patient preferences.

Indexed as

NeoplasmsPatient PreferenceTerminal CareAdultAdvance DirectivesAgedAged, 80 and overAttitude to DeathFamilyFemaleHumansMaleMiddle AgedResuscitation OrdersSurveys and QuestionnairesAdvance care planningAdvance directivesCancerEnd-of-life careQuality of lifeResuscitation orders

Identifiers

PMID40779038

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.