Advancing the field of communication research in pediatric oncology: A systematic review of the literature analyzing medical dialogue

Abstract

Historically, communication research in pediatric oncology has relied on surveys and interviews, resulting in cross-sectional and retrospective studies constrained by selection, recognition, and recall biases. This systematic review identifies and synthesizes the published literature analyzing primary data from recorded conversations between pediatric oncologists, patients with cancer, and their families, with the following objectives: (1) to identify the extent and content of the evidence base, (2) to describe methodological strategies utilized in the analysis of recorded medical dialogue, (3) to aggregate salient findings, and (4) to generate recommendations for future prospective research related to analysis of medical dialogue in pediatric oncology.

Longitudinal investigation of prognostic communication: Feasibility and acceptability of studying serial disease reevaluation conversations in children with high‐risk cancer

“…Although communication research in the field of pediatric oncology historically has been cross‐sectional, retrospective, and reliant on survey methodology, awareness of the value of the prospective investigation of recorded medical dialogue is growing . Data from this study demonstrate the feasibility and acceptability of recording serial prognostic discussions across a 24‐month time frame in the context of serious pediatric illness, with the ultimate goal of better understanding the evolution and impact of communication on prognostic awareness.…”

“…Improving communication around prognosis and goals of care for children, adolescents, and adults with serious illness and their families has been identified as a top research priority by experts in the fields of oncology, pediatrics, and palliative care . Historically, research specific to prognostic communication in the context of progressive cancer largely has been cross‐sectional, retrospective, and reliant on survey methodology . Over the past decade, extensive work by Koropchak et al has revolutionized this paradigm within medical oncology, demonstrating how systematic analysis of audio‐recordings of medical conversations can be used to improve prognostic communication .…”

“…In recent years, communication researchers have increasingly recognized the limitations of retrospective and/or cross‐sectional analyses . In addition to recall biases, the data derived from post hoc interviews are filtered through the lens of the listener and thereby provide an incomplete view of the communication that transpired.…”

“…In addition to recall biases, the data derived from post hoc interviews are filtered through the lens of the listener and thereby provide an incomplete view of the communication that transpired. Given these limitations, recorded medical dialogue triangulated with survey/interview data are increasingly considered to be the gold standard in prognostic communication research . Kamihara et al and Salmon et al have demonstrated the value of this mixed methods approach with both adult and pediatric patients .…”

“…10,11 Historically, research specific to prognostic communication in the context of progressive cancer largely has been cross-sectional, retrospective, and reliant on survey methodology. [12][13][14] Over the past decade, extensive work by Koropchak et al has revolutionized this paradigm within medical oncology, 15 demonstrating how systematic analysis of audio-recordings of medical conversations can be used to improve prognostic communication. 16,17 Within the field of pediatric oncology, several researchers have championed the value of qualitative analysis of third-party observation in synergy with audio-recorded interviews to advance the field of communication research.…”