{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T14:47:18Z","timestamp":1767797238471,"version":"3.49.0"},"reference-count":10,"publisher":"BMJ","issue":"12","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"unspecified","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Guidelines in Intensive Care Medicine, Development, and Evaluation (GUIDE) Group at St. Joseph\u2019s Hospital in Hamilton, Ontario, Canada"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2025,12,8]]},"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Hospitalised patients nearing the end of life (EOL) often face complex treatment decisions, leading to potential conflicts among care teams, patients and families. Palliative care consultations may enhance decision-making processes, improve satisfaction and reduce unnecessary interventions. This systematic review will assess the impact of palliative care consultations on treatment decisions, family and patient satisfaction, and psychological outcomes in hospitalised adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and analysis<\/jats:title>\n                    <jats:p>We will include randomised controlled trials comparing palliative care consultations to standard care in hospitalised adults. The primary outcomes will include decisions to withhold or withdraw treatments, patient and family satisfaction with EOL decision-making, and psychological outcomes such as anxiety, depression and post-traumatic stress disorder. Secondary outcomes will include intensive care unit (ICU) and hospital length of stay, utilisation of potentially non-beneficial treatments, and the use of institutional policies or legal actions. Databases including MEDLINE, Embase, CINAHL, Cochrane CENTRAL and PsycINFO will be systematically searched from inception to September 2025. Two independent reviewers will screen studies and extract data using Covidence. Meta-analyses will use random-effects models to generate pooled estimates for primary and secondary outcomes. Risk of bias will be assessed using the Cochrane Risk of Bias 2 tool, and evidence certainty will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation approach. Subgroup analyses will explore variations by ICU versus non-ICU settings, cancer versus non-cancer diagnoses and default versus clinician-initiated consultations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Ethics and dissemination<\/jats:title>\n                    <jats:p>Ethical approval is not required for this review. Findings will be disseminated through peer-reviewed publications and conference presentations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>PROSPERO registration number<\/jats:title>\n                    <jats:p>CRD420250624190.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-110582","type":"journal-article","created":{"date-parts":[[2025,12,25]],"date-time":"2025-12-25T06:10:57Z","timestamp":1766643057000},"page":"e110582","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Palliative care consultation for end-of-life decision-making in hospitalised patients: protocol for a systematic review and meta-analysis"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3547-6159","authenticated-orcid":false,"given":"Ghazal","family":"Haddad","sequence":"first","affiliation":[{"name":"Division of Critical Care, McMaster University Department of Medicine, Hamilton, Ontario, Canada"},{"name":"Division of Critical Care, McMaster University Department of Anaesthesia, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry","family":"Ajzenberg","sequence":"additional","affiliation":[{"name":"Division of Critical Care, McMaster University Department of Medicine, Hamilton, Ontario, Canada"},{"name":"Division of Critical Care, McMaster University Department of Anaesthesia, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F Daniel","family":"Davis","sequence":"additional","affiliation":[{"name":"Geisinger Health System, Danville, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patricia A","family":"Fogelman","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, Mount Nittany Health, State College, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karen","family":"Korzick","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary Faith","family":"Marshall","sequence":"additional","affiliation":[{"name":"University of Virginia School of Medicine, Charlottesville, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Douglas","family":"Naylor","sequence":"additional","affiliation":[{"name":"Department of Surgery-Trauma Surgery, Critical Care, and Acute Care Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sandra M","family":"Swoboda","sequence":"additional","affiliation":[{"name":"Johns Hopkins University School of Medicine and School of Nursing, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julie","family":"Reid","sequence":"additional","affiliation":[{"name":"McMaster University Department of Health Research Methods Evidence and Impact, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2874-8948","authenticated-orcid":false,"given":"Simon","family":"Oczkowski","sequence":"additional","affiliation":[{"name":"Division of Critical Care, McMaster University Department of Medicine, Hamilton, Ontario, Canada"},{"name":"Division of Critical Care, McMaster University Department of Anaesthesia, Hamilton, Ontario, Canada"},{"name":"McMaster University Department of Health Research Methods Evidence and Impact, Hamilton, Ontario, Canada"},{"name":"The Guidelines in Intensive Care Development and Evaluation (GUIDE) Group, The Research Institute of St Joe\u2019s Hamilton, Hamilton, Ontario, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"2026010703522802000_15.12.e110582.1","doi-asserted-by":"crossref","unstructured":"Olaisen RH . Data from: QuickStats: Percentage of Deaths,* by Place of Death\u2020\u2014National Vital Statistics System (US), United States, 2000\u20132018, 2020. Available: https:\/\/www.cdc.gov\/mmwr\/volumes\/69\/wr\/mm6919a4.htm","DOI":"10.15585\/mmwr.mm6919a4"},{"key":"2026010703522802000_15.12.e110582.2","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20160123"},{"key":"2026010703522802000_15.12.e110582.3","doi-asserted-by":"publisher","DOI":"10.1002\/pon.2087"},{"key":"2026010703522802000_15.12.e110582.4","doi-asserted-by":"crossref","first-page":"106586","DOI":"10.1016\/j.jstrokecerebrovasdis.2022.106586","article-title":"Collaborative Integration of Palliative Care in Critically Ill Stroke Patients in the Neurocritical Care Unit: A Single Center Pilot Study","volume":"31","author":"Kamdar","year":"2022","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"2026010703522802000_15.12.e110582.5","doi-asserted-by":"crossref","first-page":"544","DOI":"10.1177\/10499091221115732","article-title":"Early Versus Usual Palliative Care Consultation in the Intensive Care Unit","volume":"40","author":"Helgeson","year":"2023","journal-title":"Am J Hosp Palliat Care"},{"key":"2026010703522802000_15.12.e110582.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2020-002677"},{"key":"2026010703522802000_15.12.e110582.7","doi-asserted-by":"crossref","first-page":"1707","DOI":"10.1097\/CCM.0000000000004016","article-title":"Early Palliative Care Consultation in the Medical ICU: A Cluster Randomized Crossover Trial","volume":"47","author":"Ma","year":"2019","journal-title":"Crit Care Med"},{"key":"2026010703522802000_15.12.e110582.8","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2013.0409"},{"key":"2026010703522802000_15.12.e110582.9","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1186\/s12904-021-00862-8","article-title":"Quality of dying in hospital general wards: a cross-sectional study about the end-of-life care","volume":"20","author":"Binda","year":"2021","journal-title":"BMC Palliat Care"},{"key":"2026010703522802000_15.12.e110582.10","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0652"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-110582","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T11:54:28Z","timestamp":1767786868000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-110582"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12]]},"references-count":10,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,12,24]]},"published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1136\/bmjopen-2025-110582"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-110582","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12]]}}}