Current opinion in supportive and palliative care
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Curr Opin Support Palliat Care · Dec 2012
ReviewIntegrating technology into palliative care research.
As palliative care research evolves and grows within resource-strained environments, further integration of novel methods to assist in completing protocols is needed. Technology-assisted techniques, including the use of software and hardware, to aid in data collection, analysis and reporting are increasingly being incorporated into research investigations in palliative care. Reviewing reported successes of technology use in palliative care research is important to communicate lessons learned and principles to guide further implementation. ⋯ Technology has been successfully integrated into some aspects of palliative care research. The growth of both palliative care research and use of electronic methods for data collection predict increased incorporation between the two fields.
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Curr Opin Support Palliat Care · Dec 2012
ReviewAchieving palliative care research efficiency through defining and benchmarking performance metrics.
Research efficiency is gaining increasing attention in the research enterprise, including palliative care research. The importance of generating meaningful findings and translating these scientific advances to improved patient care creates urgency in the field to address well documented system inefficiencies. The Palliative Care Research Cooperative Group (PCRC) provides useful examples for ensuring research efficiency in palliative care. ⋯ Examples from the PCRC affirm and expand the existing literature on research efficiency, providing a palliative care focus. Operating procedures, performance metrics, prioritization, and monitoring for success should all be informed by and inform the process map to achieve maximum research efficiency.
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Curr Opin Support Palliat Care · Dec 2012
ReviewChallenges in defining 'palliative care' for the purposes of clinical trials.
Palliative care has become part of mainstream medicine with increasing evidence about the effectiveness of specialist palliative care (SPC) on patient and family outcomes. Comparison of studies testing SPC interventions is challenging as types of interventions and reporting of components of the intervention vary. In consequence, study results are difficult to interpret. ⋯ Due to the lack of an agreed definition of palliative care and heterogeneity in reporting of components of an SPC intervention comparison of studies remains challenging. Key aspects of palliative care interventions are incurable disease, multidisciplinary approach, focus on symptom management including standardized assessment, psychosocial and family support, and (advance) care planning. Detailed information about all aspects of the intervention should be provided.
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The aim of this review is to summarize the current state of the science in physical symptoms and other end-of-life care domains and/or illness-specific outcomes in palliative care. The review includes progress in outcome measure development and interpretation, with specific reference to the clinical trial context. ⋯ Clinical trials of palliative care interventions need to consider a range of outcomes, however, the choice and timing of measurement of the primary outcome need to be guided by the domain most likely to be influenced by the intervention.
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Curr Opin Support Palliat Care · Dec 2012
Advancing the science of hospice care: Coalition of Hospices Organized to Investigate Comparative Effectiveness.
There is very little high-quality evidence to guide clinical practice in hospice care. In the areas of medical therapy, patient-centered and family-centered outcomes, and patient safety, there are numerous high-impact questions for which answers are needed. Although randomized controlled trials are the gold standard for research, such trials are difficult, time consuming, and expensive to conduct in a hospice population. Moreover, they cannot examine the implementation of therapies in real-world settings. Therefore, there is a need for novel, complementary approaches to research in this unique population. ⋯ CHOICE is a growing research network that has the potential to make a contribution to the science of palliative care in a hospice population.