Should “bad news” be disclosed in person or by telephone? A systematic review and meta-analysis: Presenter(s): Katharina Beck, University Hospital Basel, Switzerland

Communication of “bad news” (such as a new cancer diagnosis) to patients may have a major impact on their well-being. We aimed to investigate differences in psychological distress of breaking bad news in person compared to by telephone in a systematic review and meta-analysis. We included all studies that investigated breaking bad news (such as a new cancer diagnosis or genetic risk for life-limiting diseases) in person compared to by telephone in adult patients regardless of diagnosis regarding the association with symptoms of anxiety, depression or post-traumatic stress disorder. We systematically searched PubMed, Embase, PsycINFO and CINAHL from the inception of each database to June 1, 2021. We included randomized and non-randomized trials. We screened 3625 studies and included eleven studies in the qualitative analysis and nine in the meta-analyses, including four randomized controlled trials. Overall, quality of studies was moderate to good. There was no mean difference regarding psychological distress when bad news was disclosed by telephone compared to in person with similar symptom levels of anxiety (3 studies, 285 participants; standardized mean difference [SMD] 0.10 [95% CI -0.15 to 0.35]), depression (3 studies, 248 participants; SMD 0.10 [95% CI -0.30 to 0.49]), and symptom levels of PTSD (2 studies, 171 participants; SMD -0.01 [95% CI -0.48 to 0.36]). Results: were similar for satisfaction with care. We did not find a difference in psychological distress if breaking bad news was done in person or by telephone but there were too few studies to draw more definite conclusions. Future research is needed to understand in which situation a telephone consultation is appropriate to disclose bad news with a patient.