• Amy P Abernethy, Arif H Kamal, Jane L Wheeler, and Christopher Cox.
• Division of Medical Oncology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA. amy.abernethy@duke.edu
• Curr Opin Support Palliat Care. 2011 Jun 1;5(2):101-10.

Purpose Of ReviewThis review addresses a distressing symptom experienced by many palliative care patients, for which available interventions have been only partially effective. A new model of healthcare delivery and research - rapid learning healthcare - provides a potential framework for improving clinical care for and outcomes of dyspnea. This review places dyspnea management in palliative care within the new systems approach offered by rapid learning healthcare.Recent FindingsResults of important studies in dyspnea are briefly presented, though the focus of this review is on evidence supporting implementation of a rapid learning model for palliative symptom management. Recent findings suggest that a rapid learning system is feasible and acceptable to patients with advanced illness, helps monitor symptoms over time, facilitates study of the impact of novel interventions, and can identify unrecognized needs and concerns.SummaryA rapid learning model could improve comprehensive assessment, timeliness of intervention, accrual of data to support best practice, and tailoring of care to patients' needs as their disease and experiences change over time. Data collected in the process of routine care in a rapid learning model can simultaneously function as clinical information and a resource for research on patient-centered experiences and outcomes.

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