title: Clinician-patient communication: evidence-based recommendations to guide practice in cancer.
abstract: OBJECTIVE
  To develop recommendations for effective communication between cancer health care providers and patients based on a systematic review of methods of clinician-patient communication that may affect patient outcomes associated with distress at critical points in the course of cancer care.
  
  
  METHODS
  A systematic review of the literature was conducted, and evidence-based recommendations were formulated to guide clinician-patient communication in cancer care. A formal external review was conducted to validate the relevance of these recommendations.
  
  
  RESULTS
  Recommendations for communication in cancer care are presented, based on guidelines from the Australian National Breast Cancer Centre and the Australian National Cancer Control Initiative,an updated systematic review of the research evidence, and a consensus by the Clinician-Patient Communications Working Panel of the Program in Evidence-Based Care of Cancer Care Ontario. The recommendations were sent to 110 Ontario practitioners for external review: 33 responded (30% response rate). Most of these respondents (87%) agreed with the draft recommendations and approved of their use as a practice guideline (90%). A condensed version of the recommendations, including 10 key points, was also created.
  
  
  CONCLUSIONS
  There is evidence to support general clinician-patient communication approaches, although the preferences of cancer patients regarding such communication exhibit individual and cultural variability. Recommendations are provided, based on evidence, the consensus of an expert panel, and feedback from a survey of external practitioners. Evidence evaluating the role of decision aids and strategies to facilitate better communication is inconsistent, although such tools may be of value for some patients.
authors.affiliation: Department of Psychosocial Oncology and Palliative Care, Princess Margaret Hospital, University Health Network, Toronto, ON. Gary.Rodin@uhn.on.ca
authors.forename: G
authors.initials: G
authors.lastname: Rodin
authors.forename: C
authors.initials: C
authors.lastname: Zimmermann
authors.forename: C
authors.initials: C
authors.lastname: Mayer
authors.forename: D
authors.initials: D
authors.lastname: Howell
authors.forename: M
authors.initials: M
authors.lastname: Katz
authors.forename: J
authors.initials: J
authors.lastname: Sussman
authors.forename: J A
authors.initials: JA
authors.lastname: Mackay
authors.forename: M
authors.initials: M
authors.lastname: Brouwers