On 2017 May 04, Cicely Saunders Institute Journal Club commented:

This paper was discussed on 2.5.17, by students on the KCL Cicely Saunders Institute MSc in Palliative Care

We read with interest the systematic review article by Cahill et al on the evidence for conducting palliative care family meetings.

We congratulate the authors on their effort to include as many papers as possible by using a wide search strategy. Ultimately, only a small number of papers were relevant to this review and were included. The authors found significant heterogeneity within the various studies, in terms of the patient settings, interviewer background, and country of origin and culture. Study methods included both qualitative and quantitative designs, and a range of outcome measures, but there was a notable lack of RCT studies.

Two studies found a benefit of family meetings using validated outcome measures. A further four found a positive outcome of family meetings, but with non-validated outcome measures. We felt that the lack of validated outcome measures does not necessarily exclude their value.

We agree with the conclusions of the authors that there is limited evidence for family meetings in the literature and that further research would be of value. The small and diverse sample size leads to the potential for a beta error (not finding a difference where one exists). We were surprised by the final statement of the abstract that family meetings should not be routinely adopted into clinical practice, and we do not feel that the data in the paper support this: the absence of finding is not synonymous to the finding of absence. Further, our experience in three health care settings (UK, Canada, Switzerland) is that family meetings are already widely and routinely used.

Aina Zehnder, Emma Hernandez-Wyatt, James W Tam

On 2017 May 04, Cicely Saunders Institute Journal Club commented:

This paper was discussed on 2.5.17, by students on the KCL Cicely Saunders Institute MSc in Palliative Care

We read with interest the systematic review article by Cahill et al on the evidence for conducting palliative care family meetings.

We congratulate the authors on their effort to include as many papers as possible by using a wide search strategy. Ultimately, only a small number of papers were relevant to this review and were included. The authors found significant heterogeneity within the various studies, in terms of the patient settings, interviewer background, and country of origin and culture. Study methods included both qualitative and quantitative designs, and a range of outcome measures, but there was a notable lack of RCT studies.

Two studies found a benefit of family meetings using validated outcome measures. A further four found a positive outcome of family meetings, but with non-validated outcome measures. We felt that the lack of validated outcome measures does not necessarily exclude their value.

We agree with the conclusions of the authors that there is limited evidence for family meetings in the literature and that further research would be of value. The small and diverse sample size leads to the potential for a beta error (not finding a difference where one exists). We were surprised by the final statement of the abstract that family meetings should not be routinely adopted into clinical practice, and we do not feel that the data in the paper support this: the absence of finding is not synonymous to the finding of absence. Further, our experience in three health care settings (UK, Canada, Switzerland) is that family meetings are already widely and routinely used.

Aina Zehnder, Emma Hernandez-Wyatt, James W Tam