Summary of findings for the main comparison.
Communication skills training compared with no communication skills training for improving healthcare professionals (HCP) communication with cancer patients | ||||
Patient or population: healthcare professionals working with patients with cancer Settings: outpatient or primary care Intervention: A communications skills training program Comparison: No communication skill training | ||||
Outcomes | Relative effect: (P value) | No of participant interviews (studies) | Quality of the evidence (GRADE) | Comments |
HCP showed 'empathy' | Favoured the intervention (P = 0.004) |
727 (6 studies) |
⊕⊕⊕⊕ high | These data were consistent and did not display statistical heterogeneity (I² = 0%). |
HCP used 'open questions' | Favoured the intervention (P = 0.04) |
679 (5 studies) | ⊕⊕⊕⊝ moderate | We downgraded the quality of the evidence due to the statistical heterogeneity of the studies (I² = 65%). |
HCP 'gave facts only' (simulated patients only) | Favoured the control group (P = 0.01) |
406 (4 studies) | ⊕⊕⊕⊝ moderate | We downgraded the quality of this evidence due to the clinical and statistical heterogeneity of the studies (I² = 70%).This effect was not evident in the subgroup of 'real patients'. Tests for subgroup differences were statistically significant. |
Patient satisfaction with communication | Not significantly different P = 0.36 |
429 (2 studies) | ⊕⊕⊝⊝ low | We downgraded the quality of the evidence due to clinical and statistical heterogeneity (I² = 74%) and the fact that only two studies contributed data. |
Patient anxiety: State trait Anxiety Inventory | Favoured the control group (P = 0.02) |
169 (2 studies) |
⊕⊝⊝⊝ very low | We downgraded the quality of the evidence due to the clinical heterogeneity of the studies and the fact that only two studies contributed data. In addition, one of these studies reported baseline differences in anxiety between the two groups (significantly higher in the control group) and it was not clear from the report whether the results were adjusted for this difference. |
GRADE Working Group grades of evidence: High quality: Further research is very unlikely to change our confidence in the estimate of effect. Moderate quality: Further research is likely to have an important impact on our confidence in the estimate of effect and may change the estimate. Low quality: Further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Very low quality: We are very uncertain about the estimate. |