SynthesisBMJ supportive & palliative care2026
Goals of care discussions in hospitalised patients: systematic review of randomised trials.
Synthesis in BMJ supportive & palliative care, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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
0 citing papers in PubMed.
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
importanceStructured communication tools and decision aids are recommended to facilitate goals of care discussions (GOCDs) in hospitalised patients, but their impact remains unclear.
objectiveTo determine the effectiveness of communication tools and decision aids on GOCDs between healthcare providers, patients and substitute decision makers. DATA SOURCES: PubMed, Web of Science, CINAHL and ClinicalTrials.gov were searched from January 2015 to July 2025, with backward citation tracking to identify additional trials. STUDY SELECTION: Randomised trials of communication tools or decision aids for hospitalised adults or substitute decision makers were eligible, regardless of primary outcomes. DATA EXTRACTION AND SYNTHESIS: Trial characteristics, primary outcomes and methodological quality were extracted and assessed using the Core Grading of Recommendations, Assessment, Development and Evaluation framework. Random-effects meta-analyses were conducted when appropriate.
results22 trials were included. Communication tools increased GOCD documentation (OR 1.46, 95% CI 1.04 to 2.05). Effects on resuscitation preferences were inconsistent (OR 1.84, 95% CI 0.95 to 3.60). Mixed effects were observed for concordant care, psychosocial outcomes and healthcare utilisation. Evidence certainty was moderate for most outcomes; several small pilot trials were rated low due to bias, imprecision or heterogeneity. Interventions were most effective when combining structured patient-facing or clinician-facing prompts such as videos, guides or electronic health record alerts. CONCLUSIONS AND RELEVANCE: Communication tools and decision aids improve GOCD documentation in hospitalised patients but show uncertain effects on other patient-centred outcomes or healthcare utilisation. Interprofessional training and system-level support may enhance impact, and future large trials should evaluate the effectiveness of facilitated GOCDs on important patient and health system outcomes.
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