{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T23:23:58Z","timestamp":1778801038256,"version":"3.51.4"},"reference-count":35,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T00:00:00Z","timestamp":1661299200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Most pediatric patients and families want clear prognostic information across the illness course. Yet when children with poor\u2010prognosis cancer experience prolonged disease stability, uncertainty can make communication particularly challenging. In this study, we aimed to (i) assess how frequently oncologists communicate about prognosis when high\u2010risk cancer does not progress, and (ii) describe prognostic communication patterns in the context of disease stability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods<\/jats:title>\n                    <jats:p>In this prospective, longitudinal, mixed\u2010methods study, we audio\u2010recorded serial disease re\u2010evaluation conversations between children with poor\u2010prognosis cancer, their families, and their primary oncologists. For this secondary analysis, we conducted content analysis across serial conversations among 16 patient\u2013parent\u2013oncologist triads for whom the patient's disease remained stable over the 24\u2010month study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Prognostic communication was absent in &gt;50% of recorded conversations. Overall, it comprised only 4% of dialog time, nearly 90% of which was dialog about prognostic uncertainty; discussion of curability occurred infrequently. Three distinct patterns for prognostic communication emerged: (a) \u201cDon't know\u201d statements, avoiding or deferring prognostication; (b) \u201cWorry\u201d statements, preparing families for possible future disease progression; and (c) relief\u2010caveat statements, celebrating disease stability while balancing positivity with caution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Oncologists seldom talked about prognosis with high\u2010risk patients during periods of disease stability; yet when they did, they used thoughtful and effective strategies to prepare families for possible future disease progression. Further research is needed to better understand if, how, and when patients and families with stable disease who are high risk for future disease progression prefer to receive information about prognosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pbc.29920","type":"journal-article","created":{"date-parts":[[2022,8,24]],"date-time":"2022-08-24T09:20:08Z","timestamp":1661332808000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Navigating prognostic communication when children with poor\u2010prognosis cancer experience prolonged disease stability"],"prefix":"10.1002","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7812-0286","authenticated-orcid":false,"given":"Amy S.","family":"Porter","sequence":"first","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emma","family":"Chow","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital  Memphis Tennessee USA"},{"name":"Rhodes College  Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cameka","family":"Woods","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica E.","family":"Lemmon","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Duke Children's Health Center  Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin N.","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5791-4178","authenticated-orcid":false,"given":"Jennifer W.","family":"Mack","sequence":"additional","affiliation":[{"name":"Department of Pediatric Oncology Dana\u2010Farber Cancer Institute  Boston Massachusetts USA"},{"name":"Department of Pediatrics Boston Children's Hospital  Boston Massachusetts USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6522-3876","authenticated-orcid":false,"given":"Erica C.","family":"Kaye","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,8,24]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.30716"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32533"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013\u20103608E"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1542\/PEDS.2019\u20102771"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.6110"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.31772"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.08.3170"},{"key":"e_1_2_10_9_1","first-page":"55","volume-title":"Pediatric Oncology","author":"Kaye EC","year":"2018"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020\u2010044503"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.75.6288"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.06.5326"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.26727"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2021\u2010055980"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3978\/J.ISSN.2224\u20105820.2015.08.04"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1136\/BMJ.327.7408.195"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2019.08.010"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2020.10.006"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41416\u2010021\u201001512\u20109"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.29270"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.20925"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.06.5326"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.6110"},{"key":"e_1_2_10_25_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.6059"},{"issue":"1","key":"e_1_2_10_26_1","article-title":"CAQDAS and qualitative syllogism logic \u2014 NVivo 8 and MAXQDA 10 compared","volume":"12","author":"Sch\u00f6nfelder W","year":"2011","journal-title":"Qual Sozialforsch\/Forum Qual Soc Res"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1177\/1744987107081254"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2015.63.6696"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2018.78.2128"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.27699"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1634\/theoncologist.5\u20104\u2010302"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1188\/10.CJON.514\u2010516"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.75.2311"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2017.75.6288"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11135\u2010017\u20100574\u20108"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1080\/13814788.2017.1375092"}],"container-title":["Pediatric Blood &amp; Cancer"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.29920","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pbc.29920","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pbc.29920","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T01:54:46Z","timestamp":1692496486000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pbc.29920"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,24]]},"references-count":35,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2023,1]]}},"alternative-id":["10.1002\/pbc.29920"],"URL":"https:\/\/doi.org\/10.1002\/pbc.29920","archive":["Portico"],"relation":{"has-review":[{"id-type":"doi","id":"10.3410\/f.742292189.793595968","asserted-by":"object"}]},"ISSN":["1545-5009","1545-5017"],"issn-type":[{"value":"1545-5009","type":"print"},{"value":"1545-5017","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,24]]},"assertion":[{"value":"2022-06-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-24","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e29920"}}