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Palliative care consultation for end-of-life decision-making in hospitalised patients: protocol for a systematic review and meta-analysis

Por: Haddad · G. · Ajzenberg · H. · Davis · F. D. · Fogelman · P. A. · Korzick · K. · Marshall · M. F. · Naylor · D. · Swoboda · S. M. · Reid · J. · Oczkowski · S.
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.

A Comprehensive Scoping Review on the Use of Point‐Of‐Care Infrared Thermography Devices for Assessing Various Wound Types

ABSTRACT

This scoping review investigates the use of point-of-care infrared thermography devices for assessing various wound types. A comprehensive search across four databases yielded 76 studies published between 2010 and 2024 that met the inclusion criteria. The review highlights thermography applications in burns, surgical wounds, diabetic foot ulcers, pressure injuries, and other lower limb wounds. Key findings indicate its effectiveness in detecting early signs of inflammation and healing delays, facilitating timely interventions. The technology shows promise in accurately predicting wound healing trajectories and assessing treatment outcomes. Recent advancements have made thermographic devices more affordable and user-friendly, expanding their clinical potential. However, challenges persist, including reimbursement, training requirements, and integration with electronic medical records (EMRs), with EMR integration identified as a critical barrier to widespread adoption. While preliminary findings are promising, the current evidence base is constrained by small sample sizes, retrospective study designs, and limited consideration of skin tone variability. Large, prospective studies are essential to validate the clinical utility of thermography in wound care and to inform the development of standardised protocols that support equitable, bias-reduced assessment across diverse populations. Addressing these gaps is critical for advancing research, enhancing clinician training, and improving patient outcomes in wound care. Overall, point-of-care thermography demonstrates significant potential to enhance wound assessment and monitoring, thereby elevating care quality and patient outcomes.

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