Paper in Annals of Oncology
- Hagerty, R. G., Butow,
P. N., Ellis, P. M., Dimitry, S. and Tattersall,
M. H. N. (2005) Communicating prognosis in cancer care:
a systematic review of the literature. Annals of Oncology,
16: 1005 - 1053
Prognosis is an issue that most doctors and patients describe
as difficult to discuss and the best way of presenting prognostic
information to optimise patient understanding, psychological
adjustment and decision-making is uncertain. A systematic review
of the literature was conducted with the aim of clarifying the
current available knowledge of patient preferences, clinician
views and current practice regarding the communication of prognosis.
Eleven primary research questions guided organisation of the
review findings, which were: patient preferences for prognostic
information and preferred style of communicating prognosis;
disclosure of prognosis to family members; physicians' views
on communication of prognosis; current practice of delivering
prognostic information; patient understanding and awareness
of prognostic information; cultural differences in preferences
and understanding; impact of prognostic information on patient
outcomes; and interventions to facilitate prognostic discussion.
Predictors of patient preferences for and understanding of prognostic
information were also summarised. Studies are summarised under
the subcategories according to the participants' disease stage.
It was found that the majority of the published research has
been conducted in the early stage cancer setting providing mostly
descriptive evidence, and there is little evidence of the best
method of communicating prognosis or of the impact of prognostic
information on patient outcomes.