ReviewGalen medical journal2025
Early Versus Late Pediatric Palliative Care in Oncology: A Systematic Review of Outcomes, Disparities, and Implementation Barriers : Palliative Care in Oncology.
Review in Galen medical journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This systematic review, conducted per PRISMA 2020 guidelines, synthesizes evidence on early pediatric palliative care (PPC) versus late or no PPC in children and young adults (0-21 years) with life-threatening oncologic illnesses. A comprehensive search of MEDLINE, Embase, Scopus, PsycINFO, Web of Science, Cochrane Central, and grey literature (ProQuest, ClinicalTrials.gov) from inception to 1 August 2025 identified 12 studies, including retrospective cohorts, surveys, and one randomized controlled trial across the USA, Canada, Taiwan, and Spain. Early PPC, variably defined as initiation from diagnosis to 12 months before death, consistently reduced end-of-life care intensity (fewer ICU admissions, mechanical ventilation, invasive interventions), increased hospice enrollment, home deaths, and improved quality of life and symptom management compared to late or no PPC. Disparities were evident, with minority groups and patients with hematologic malignancies less likely to receive early PPC, compounded by barriers such as provider misconceptions, systemic limitations, and clinical trial enrollment delays. Outpatient and integrated home-hospital PPC models significantly lowered hospital-based end-of-life care, though robust late PPC programs could achieve comparable outcomes. Narrative synthesis using the GRADE approach highlighted moderate to high confidence in reduced care intensity and improved family outcomes with early PPC, despite heterogeneous definitions and study designs precluding meta-analysis. Findings show the need for standardized PPC protocols, education to address provider barriers, and policy reforms to enhance equitable access, particularly for underserved populations. While oncology evidence is robust, further randomized trials are needed to strengthen findings across other conditions, supporting early PPC integration to optimize patient and family outcomes in pediatric oncology.
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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.