{
  "abstract": "Introduction 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.Methods and analysis 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.Ethics and dissemination Ethical approval is not required for this review. Findings will be disseminated through peer-reviewed publications and conference presentations.PROSPERO registration number CRD420250624190.",
  "authors": [
    {
      "affiliations": [
        "Division of Critical Care, McMaster University Department of Medicine, Hamilton, Ontario, Canada",
        "Division of Critical Care, McMaster University Department of Anaesthesia, Hamilton, Ontario, Canada"
      ],
      "name": "Ghazal Haddad"
    },
    {
      "affiliations": [
        "Division of Critical Care, McMaster University Department of Medicine, Hamilton, Ontario, Canada",
        "Division of Critical Care, McMaster University Department of Anaesthesia, Hamilton, Ontario, Canada"
      ],
      "name": "Henry Ajzenberg"
    },
    {
      "affiliations": [
        "Geisinger Health System, Danville, Pennsylvania, USA"
      ],
      "name": "F Daniel Davis"
    },
    {
      "affiliations": [
        "Department of Palliative Medicine, Mount Nittany Health, State College, Pennsylvania, USA"
      ],
      "name": "Patricia A Fogelman"
    },
    {
      "affiliations": [
        "Department of Pulmonary and Critical Care Medicine, Geisinger Medical Center, Danville, Pennsylvania, USA"
      ],
      "name": "Karen Korzick"
    },
    {
      "affiliations": [
        "University of Virginia School of Medicine, Charlottesville, Virginia, USA"
      ],
      "name": "Mary Faith Marshall"
    },
    {
      "affiliations": [
        "Department of Surgery-Trauma Surgery, Critical Care, and Acute Care Surgery, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA"
      ],
      "name": "Douglas Naylor"
    },
    {
      "affiliations": [
        "Johns Hopkins University School of Medicine and School of Nursing, Baltimore, Maryland, USA"
      ],
      "name": "Sandra M Swoboda"
    },
    {
      "affiliations": [
        "McMaster University Department of Health Research Methods Evidence and Impact, Hamilton, Ontario, Canada"
      ],
      "name": "Julie Reid"
    },
    {
      "affiliations": [
        "Division of Critical Care, McMaster University Department of Medicine, Hamilton, Ontario, Canada",
        "Division of Critical Care, McMaster University Department of Anaesthesia, Hamilton, Ontario, Canada",
        "McMaster University Department of Health Research Methods Evidence and Impact, Hamilton, Ontario, Canada",
        "The Guidelines in Intensive Care Development and Evaluation (GUIDE) Group, The Research Institute of St Joe’s Hamilton, Hamilton, Ontario, Canada"
      ],
      "name": "Simon Oczkowski"
    }
  ],
  "title": "Palliative care consultation for end-of-life decision-making in hospitalised patients: protocol for a systematic review and meta-analysis",
  "uid": "87d389e9-a714-5c84-8e18-289d3b323e27"
}