Eligibility criteria

Original quantitative studies describing the association between physician-patient communication about prognosis and patient outcomes in palliative cancer care were eligible. Palliative cancer care was defined as care for patients with incurable, metastatic cancer, including end-of-life care. Studies with samples partially matching the target population were only included if subgroup results were available. Communication about prognosis was defined as communicating the absence of cure, terminal nature of the disease and/or life expectancy. Papers addressing “bad news” without specifying its definition did not suffice. Communication could be real (e.g. self-reported by physicians or patients or observed in medical records, audio-recorded consultations or individually adapted consultations) or hypothetical (e.g. manipulated in video-recorded or written vignettes). Studies qualified if the independent effect of (strategies for) prognostic disclosure on (any type of) patient outcome(s) was examined. Hence, studies investigating more general interventions, such as advance care planning, early palliative care, decisions aids, question prompt lists or communication skills training, were excluded. Qualitative and non-empirical research, case reports and studies investigating minors or caregivers were also excluded.