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Cao H, Chen Y, Yang Z, Lan J, Sum-Wing Kwong J, Zhang R, Zhao H, Hu L, Wang J, Sun S, Tan S, Cao J, He R, Zheng W, Zhang J. The methodological quality of systematic reviews regarding the Core Outcome Set (COS) development. BMC Med Res Methodol 2024; 24:65. [PMID: 38468223 PMCID: PMC10926669 DOI: 10.1186/s12874-024-02182-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 02/16/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND The Core Outcome Measures in Effectiveness Trials (COMET) working group proposed core outcome sets (COS) to address the heterogeneity in outcome measures in clinical studies. According to the recommendations of COMET, performing systematic reviews (SRs) usually was the first step for COS development. However, the SRs that serve as a basis for COS are not specifically appraised by organizations such as COMET regarding their quality. Here, we investigated the status of SRs related to development of COS and evaluated their methodological quality. METHODS We conducted a search on PubMed to identify SRs related to COS development published from inception to May 2022. We qualitatively summarized the disease included in SR topics, and the studies included in the SRs. We evaluated the methodological quality of the SRs using AMSTAR 2.0 and compared the overall quality of SRs with and without protocols using the Mann-Whitney U test. RESULTS We included 175 SRs from 23 different countries or regions, and they mainly focused on five diseases: musculoskeletal system or connective tissue disease (n = 19, 10.86%), injury, poisoning, or certain other consequences of external causes (n = 18, 10.29%), digestive system disease (n = 16, 9.14%), nervous system disease (n = 15, 8.57%), and genitourinary system disease (n = 15, 8.57%). Although 88.00% of SRs included randomized controlled trials (RCTs), only a few SRs (23.38%) employed appropriate tools to assess the risk of bias in RCTs. The assessment results on the basis of AMSTAR 2.0 indicated that most SRs (93.71%) were rated as ''critically low'' to ''low'' in terms of overall confidence. The overall confidence of SRs with protocols was significantly higher than that without protocols (P <.001). Compared to the SRs with protocols on Core Outcome Measures in Effectiveness Trials (COMET), SRs with protocols on PROSPERO were of better overall confidence (P = .017). CONCLUSION The overall quality of published SRs regarding COS development was poor. Our findings emphasize the need for researchers to carefully select the disease topic and strictly adhere to the requirements of optimal methodology when conducting a SR for the establishment of a COS.
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Affiliation(s)
- Hong Cao
- School of Pharmaceutical Sciences, Guizhou University, 2708 South of Huaxi Avenue Road, Guiyang, China
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Yan Chen
- School of Pharmaceutical Sciences, Guizhou University, 2708 South of Huaxi Avenue Road, Guiyang, China
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Zhihao Yang
- Department of Health Services Management, Guizhou Medical University, Shansi Building, Huaxi College Town, Guiyang, China
| | - Junjie Lan
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Joey Sum-Wing Kwong
- Global Health Nursing, Graduate School of Nursing Science, St. Luke's International University, 10-1 Akashi-choChuo-Ku 104-0044, Tokyo, Japan
| | - Rui Zhang
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Huaye Zhao
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Linfang Hu
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Jiaxue Wang
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Shuimei Sun
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Songsong Tan
- Office of Health Insurance Administration, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Jinyong Cao
- Department of endoscopy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China
| | - Rui He
- Experimental Cancer Medicine, Department of Laboratory Medicine, Karolinska Institute, Room 601, Novum PI 6, Hälsovägen 7, SE-14157 Huddinge, Stockholm, Sweden
| | - Wenyi Zheng
- Experimental Cancer Medicine, Department of Laboratory Medicine, Karolinska Institute, Room 601, Novum PI 6, Hälsovägen 7, SE-14157 Huddinge, Stockholm, Sweden
| | - Jiaxing Zhang
- Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China.
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Wakefield D, Ta Y, Dewhurst F, Hussain J, Chamberlain C, Etkind S. Qualified and motivated, but limited by specialty-specific barriers: a national survey of UK Palliative Medicine consultants research experience. BMJ Support Palliat Care 2024; 14:76-86. [PMID: 37611937 DOI: 10.1136/spcare-2023-004198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 07/20/2023] [Indexed: 08/25/2023]
Abstract
OBJECTIVES Providing high-quality safe palliative care requires high-quality clinically driven research. Little is known about how to optimise clinical research capacity in this field.To understand interest and capacity to conduct clinical research in palliative medicine and identify key facilitators and barriers, by surveying palliative medicine consultants and academic trainees. METHODS National online survey exploring experience in conducting research, including facilitators and barriers. Sent to all current UK palliative medicine consultants, and previous/current academic trainees. Descriptive statistics are reported with framework analysis of free text responses. RESULTS 195 surveys were submitted including 15 respondents with Integrated Academic Training (IAT) experience. 78% (n=140/180) of consultants were interested in conducting research. Despite this enthusiasm, 83% had no allocated time within their job plan. 88% of those who undertook IAT would recommend IAT, but 60% reported difficulty transitioning from academic trainee to research active consultant.Barriers to research included; insufficient research culture and integration, with small teams working in a mixture of National Health Service (NHS) and non-NHS settings, leading to isolated, silo working. Even those who had undertaken IAT, felt a 'cliff edge' in opportunities after completing IAT. Filling service gaps was routinely prioritised over research activity. CONCLUSION Palliative medicine consultants, including those who have completed academic training want to conduct research but overwhelming barriers limit activity. A palliative care-specific strategy that permeates different palliative care settings, promotes interspecialty collaboration and improves the current infrastructure for palliative care research to maximise gains from IAT and embed a research culture are suggested.
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Affiliation(s)
- Donna Wakefield
- North Tees and Hartlepool NHS Foundation Trust, Stockton-Upon-Tees, UK
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | | | - Felicity Dewhurst
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
- St Oswald's Hospice, Newcastle upon Tyne, UK
| | - Jamilla Hussain
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
| | - Charlotte Chamberlain
- Faculty of Health Sciences, University of Bristol, Bristol, UK
- University Hospitals Bristol & Weston NHS Foundation Trust, Bristol, UK
| | - Simon Etkind
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, King's College London, London, UK
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Cooper S, Denholm M, Malek AS, Rubasingham JA, Tsang D. Palliative radiotherapy: survival prognostic factors - single-centre retrospective cohort study. BMJ Support Palliat Care 2024:spcare-2024-004810. [PMID: 38378244 DOI: 10.1136/spcare-2024-004810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE Patients with non-curative malignancy can receive palliative radiotherapy (PR) to alleviate symptoms. However, choosing the right patient to receive PR can be challenging, as some patients may not survive long enough to gain benefit. This study aims to identify prognostic factors for overall survival (OS) and 30-day mortality (30DM) following PR and to test these in a real-world cohort. METHOD A retrospectively collected data set of all adults completing PR between 1 August 2018 and 31 December 2018 at a single centre (n=214, Southend University Hospital NHS Foundation Trust, UK) was used to test prognostic factors. Factors such as demographics, tumour primary, treatment area, fractionation regime, performance status (PS), progressive disease (PD), opioid or steroid use and haemoglobin level, as well as overall survival, were collected. Cox regression was used to examine survival predictors, and logistic regression was used to determine the predictive strength of factors for 30DM. RESULTS Overall 30DM was 14%. There was significantly worse survival in patients with poor PS (HR 1.2406, 95% CI 0.94 to 1.64. p=0.01). Patients with PS 3 had a median OS of 75 days and were more likely to experience 30DM (OR 6.2, 95% CI 1.226 to 45.42, p=0.03). Patients with PD outside of the radiation field (46%, 30 out of 65 documented) had significantly worse OS (HR 5.24, 95% CI 2.19 to 12.5, p<0.001). CONCLUSION Poor PS and PD were prognostic of OS and 30DM. Future work should include validation with a prospectively collected cohort.
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Affiliation(s)
- Sian Cooper
- Southend University Hospital, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, UK
| | - Mary Denholm
- Department of Oncology, Early Cancer Institute, Cambridge, UK
- Department of Oncology, Addenbrooke's Hospital, Cambridge, UK
| | | | | | - David Tsang
- Southend University Hospital, Mid and South Essex NHS Foundation Trust, Southend-on-Sea, UK
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Clarke G, Hussain JA, Allsop MJ, Bennett MI. Ethnicity and palliative care: we need better data - five key considerations. BMJ Support Palliat Care 2023; 13:429-431. [PMID: 35589123 PMCID: PMC10803990 DOI: 10.1136/bmjspcare-2022-003565] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/13/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Gemma Clarke
- Academic Unit of Palliative Care, Leeds Insitute of Health Sciences, University of Leeds School of Medicine, Leeds, UK
| | | | - Matthew John Allsop
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Michael I Bennett
- Academic Unit of Palliative Care, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
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Singh BM, Kumari-Dewat N, Ryder A, Parry E, Klaire V, Matthews D, Bennion G, Jennens H, Ritzenthaler BME, Rayner S, Shears J, Ahmed K, Sidhu M, Viswanath A, Warren K. Digital health and inpatient palliative care: a cohort-controlled study. BMJ Support Palliat Care 2023:spcare-2023-004474. [PMID: 37491147 DOI: 10.1136/spcare-2023-004474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 07/17/2023] [Indexed: 07/27/2023]
Abstract
OBJECTIVES End of life has unacceptable levels of hospital admission and death. We aimed to determine the association of a novel digital specific system (Proactive Risk-Based and Data-Driven Assessment of Patients at the End of Life, PRADA) to modify such events. METHODS A cohort-controlled study of those discharged alive, who died within 90 days of discharge, comparing PRADA (n=114) with standard care (n=3730). RESULTS At 90 days, the PRADA group were more likely to die (78.9% vs 46.2%, p<0.001), had a shorter time to death (58±90 vs 178±186 days, p<0.001) but readmission (20.2% vs 37.9%, p<0.001) or death in hospital (4.4% vs 28.9%, p<0.001) was lower with reduced risk for a combined 90-day outcome of postdischarge non-elective admission or hospital death (OR 0.45, 95% CI 0.27-0.74, p<0.001). Tightening criteria with 1:1 matching (n=83 vs 83) showed persistent significant findings in PRADA contact with markedly reduced adverse events (OR 0.15, 95% CI 0.02-0.96, p<0.05). CONCLUSIONS Being seen in hospital by a specialist palliative care team using the PRADA tool was associated with significantly improved postdischarge outcomes pertaining to those destined to die after discharge.
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Affiliation(s)
- Baldev Malkit Singh
- Institute of Digital Health, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
- Research Institute for Health Sciences, University of Wolverhampton, Wolverhampton, UK
| | - Nisha Kumari-Dewat
- Community Nursing, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Adam Ryder
- Departmenet of Medicine, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Emma Parry
- Academic Unit of Primary Care, Institute of Digital Health, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
- School of Medicine, Keele University, Keele, UK
| | - Vijay Klaire
- Digital Innovation Unit, Institute of Digital Health, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Dawn Matthews
- Department of Palliative Medicine, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Gemma Bennion
- Department of Palliative Medicine, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Hannah Jennens
- Department of Palliative Medicine, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Benoit M E Ritzenthaler
- Department of Palliative Medicine, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Sophie Rayner
- Department of Palliative Medicine, Derriford Hospital, Plymouth, UK
| | - Jean Shears
- Departmenet of Medicine, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | | | - Mona Sidhu
- Lea Road Medical Practice, Wolverhampton, UK
| | - Ananth Viswanath
- Department of Diabetes and Endocrinology, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Kate Warren
- Digital Innovation Unit, Institute of Digital Health, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
- Department of Public Health, Wolverhampton City Council, Wolverhampton, UK
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Dewhurst F, Wakefield D, Elverson J, McConnell R, Bryan C, Spriggs H, Atkinson K, Frew K. Palliative care inpatients favour research participation irrespective of prognosis, performance or socioeconomic status: multicentre cohort study. BMJ Support Palliat Care 2022:spcare-2022-004037. [PMID: 36522142 DOI: 10.1136/spcare-2022-004037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 11/29/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Palliative care needs to embrace research to guide service development and effective symptom management. Healthcare professionals often feel research is too burdensome for patients who have poor performance status or are near the end of life. Many studies exclude these groups from participating.We aimed to identify whether specialist palliative care inpatients would wish to take part in research and whether preference varies according to study design, demographics, diagnosis, performance status and prognosis. METHODS 100 inpatients in two National Health Service specialist palliative care units and one independent hospice in the Northeast of England completed a short questionnaire about preferences for involvement in research. RESULTS 92% of participants stated they were interested in being involved in research. This was mostly unaffected by age, diagnosis, prognosis, performance and socioeconomic status. Three-quarters were within the last 3 months of life. Simple questions or interviews were the preferred methodology, whereas only half of patients would want further investigations or additional medications and fewer still wanted to participate in online activities, lifestyle change or group activities. CONCLUSIONS Palliative care inpatients welcome the opportunity to be involved in research and should not be excluded on the grounds of advanced disease, poor prognosis and low performance status.
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Affiliation(s)
- Felicity Dewhurst
- Population Health Sciences, Newcastle University, Newcastle upon Tyne, UK
- St Oswald's Hospice, Newcastle upon Tyne, UK
| | - Donna Wakefield
- Population Health Sciences, Newcastle University, Newcastle upon Tyne, UK
- Specialist Palliative Care Team, North Tees and Hartlepool NHS Foundation Trust, Stockton-on-Tees, UK
| | - Joanna Elverson
- St Oswald's Hospice, Newcastle upon Tyne, UK
- Specialist Palliative Care Team, Newcastle upon Tyne Hospitals NHS Trust, Newcastle upon Tyne, UK
| | | | - Charlotte Bryan
- Specialist Palliative Care Team, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | | | - Kate Atkinson
- Health Education North East, Newcastle upon Tyne, UK
| | - Katherine Frew
- Specialist Palliative Care Team, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
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Taylor R, Nelms L, Khiroya H, Willis D, Willis TA. Duchenne muscular dystrophy: adult hospice admission survey - doors open or closed? BMJ Support Palliat Care 2022:spcare-2022-003997. [PMID: 36344245 DOI: 10.1136/spcare-2022-003997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 10/19/2022] [Indexed: 11/09/2022]
Affiliation(s)
| | | | | | - Derek Willis
- Severn Hospice, Telford, UK
- England and Chester University, Chester, UK
| | - Tracey A Willis
- England and Chester University, Chester, UK
- Paediatrics, Robert Jones and Agnes Hunt Orthopaedic NHS Trust Hospital, Oswestry, UK
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Bergman TD, Pasman HRW, Hendriksen JM, Onwuteaka-Philipsen BD. End of life in general practice: trends 2009-2019. BMJ Support Palliat Care 2022:bmjspcare-2022-003609. [PMID: 36288918 DOI: 10.1136/spcare-2022-003609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 10/02/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVES To assess possible trends between 2009 and 2019 in the Netherlands of palliative care indicators: the provision of palliative care or treatment, hospitalisations in the last month before death, use of specialised palliative care services and place of death. METHODS The study design was a repeated retrospective cross-sectional design with questionnaires filled in by general practitioners within a clustered sample of 67 Sentinel practices. Patients whose death was non-sudden, and thus could have received palliative care, between 1 January 2009 and 31 December 2019 were included in the study, resulting in 3121 patients. RESULTS Between 2009 and 2019, there is a significant increase in the number of people who receive palliative care or treatment alongside life-prolonging or curative treatment and the number of people who die at home, while the number of hospitalisations in the last month before death and the number of people dying in hospital shows a significant decrease. However, there is no trend in the involvement of specialised palliative care services or people receiving solely palliative care or treatment. CONCLUSION This study suggests improvements in end-of-life care provided in primary care in the Netherlands. Trends coincided with increased attention to palliative care both in practice and policy. Yet, there is still considerable room for improvement as there is no significant increase in people solely receiving palliative care or treatment and the involvement of specialised palliative care services.
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Affiliation(s)
- Tessa D Bergman
- Department of Public and Occupational Health, Amsterdam UMC, Locatie VUmc, Amsterdam, The Netherlands
- Center of Expertise in Palliative Care, VU University Medical Centre, Amsterdam, The Netherlands
| | - H Roeline W Pasman
- Department of Public and Occupational Health, Amsterdam UMC, Locatie VUmc, Amsterdam, The Netherlands
- Center of Expertise in Palliative Care, VU University Medical Centre, Amsterdam, The Netherlands
| | - Janneke Mt Hendriksen
- Research Unit Primary Care, Netherlands Institute for Health Services Research (NIVEL), Utrecht, The Netherlands
| | - Bregje D Onwuteaka-Philipsen
- Department of Public and Occupational Health, Amsterdam UMC, Locatie VUmc, Amsterdam, The Netherlands
- Center of Expertise in Palliative Care, VU University Medical Centre, Amsterdam, The Netherlands
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Hoare S, Antunes B, Kelly MP, Barclay S. End-of-life care quality measures: beyond place of death. BMJ Support Palliat Care 2022:spcare-2022-003841. [PMID: 35859151 DOI: 10.1136/spcare-2022-003841] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 06/28/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND How quality in healthcare is measured shapes care provision, including how and what care is delivered. In end-of-life care, appropriate measurement can facilitate effective care and research, and when used in policy, highlight deficits and developments in provision and endorse the discipline necessity. The most prevalent end-of-life quality metric, place of death, is not a quality measure: it gives no indication of the quality of care or patient experience in the place of death. AIM To evaluate alternative measures to place of death for assessing quality of care in end-of-life provision in all settings. METHOD We examine current end-of-life care quality measures for use as metrics for quality in end-of-life care. We categorise approaches to measurement as either: clinical instruments, mortality follow-back surveys or organisational data. We review each category using four criteria: care setting, patient population, measure feasibility, care quality. RESULTS While many of the measure types were highly developed for their specific use, each had limitations for measuring quality of care for a population. Measures were deficient because they lacked potential for reporting end-of-life care for patients not in receipt of specialist palliative care, were reliant on patient-proxy accounts, or were not feasible across all care settings. CONCLUSION None of the current end-of-life care metric categories can currently be feasibly used to compare the quality of end-of-life care provision for all patients in all care settings. We recommend the development of a bespoke measure or judicious selection and combination of existing measures for reviewing end-of-life care quality.
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Affiliation(s)
- Sarah Hoare
- The Healthcare Improvement Studies Institute, University of Cambridge, Cambridge, UK
| | - Bárbara Antunes
- Palliative & End of Life Care in Cambridge (PELiCam), Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge Department of Public Health and Primary Care, Cambridge, UK
| | - Michael P Kelly
- Palliative & End of Life Care in Cambridge (PELiCam), Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge Department of Public Health and Primary Care, Cambridge, UK
| | - Stephen Barclay
- Palliative & End of Life Care in Cambridge (PELiCam), Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge Department of Public Health and Primary Care, Cambridge, UK
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Rombey T, Puljak L, Allers K, Ruano J, Pieper D. Inconsistent views among systematic review authors toward publishing protocols as peer-reviewed articles: an international survey. J Clin Epidemiol 2020; 123:9-17. [PMID: 32201257 DOI: 10.1016/j.jclinepi.2020.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/08/2020] [Accepted: 03/16/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES This study aimed to explore views of authors of systematic reviews (SRs) registered in the International Prospective Register of Systematic Reviews (PROSPERO) toward publishing SR protocols as peer-reviewed articles. STUDY DESIGN AND SETTING Contact persons of all PROSPERO records for non-Cochrane SRs registered in 2018 (N = 12,531) were invited to participate in an anonymous 5-minute online survey that was administered through SurveyMonkey. The main question addressed SR authors' views toward publishing SR protocols as peer-reviewed articles. Data were analyzed descriptively. RESULTS In total, 4,223 (33.7%) of 12,531 invitees responded, of which 3,739 (88.5%) completed the survey. Almost half of the international respondents had published or planned to publish a protocol for the SR described in their PROSPERO record as a peer-reviewed article (1,811/4,054; 44.7%). Most respondents agreed that publishing a protocol in a peer-reviewed journal increases SR quality as reviewers get external feedback from peer reviewers (2,899/3,739; 77.5%) but at the same time agreed that it is not necessary if the SR is registered in PROSPERO (2,399/3,739; 64.2%). CONCLUSION SR authors seem to have inconsistent views toward publishing protocols as peer-reviewed articles, and many seem to consider registration in PROSPERO (without peer review) sufficient. Hence, awareness about the benefits of publishing protocols as a peer-reviewed article in addition to registration in PROSPERO should be raised.
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Affiliation(s)
- Tanja Rombey
- Institute for Research in Operative Medicine, Faculty of Health, School of Medicine, Witten/Herdecke University, Cologne, Germany.
| | - Livia Puljak
- Center for Evidence-Based Medicine and Health Care, Catholic University of Croatia, Zagreb, Croatia
| | - Katharina Allers
- Department of Health Services Research, School of Medicine and Health Sciences, Carl von Ossietzky University Oldenburg, Oldenburg, Germany
| | - Juan Ruano
- Department of Dermatology, Hospital Universitario Reina Sofia, Cordoba, Spain; Immune-Mediated Inflammatory Skin Diseases Group, Instituto Maimonides de Investigacion Biomedica de Cordoba (IMIBIC)/Hospital Universitario Reina Sofía/Universidad de Cordoba, Cordoba, Spain
| | - Dawid Pieper
- Institute for Research in Operative Medicine, Faculty of Health, School of Medicine, Witten/Herdecke University, Cologne, Germany
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Byrne M, McSharry J, Meade O, Lavoie KL, Bacon SL. An international, Delphi consensus study to identify priorities for methodological research in behavioral trials in health research. Trials 2020; 21:292. [PMID: 32293510 PMCID: PMC7092577 DOI: 10.1186/s13063-020-04235-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Accepted: 03/09/2020] [Indexed: 11/24/2022] Open
Abstract
Background Non-communicable chronic diseases are linked to behavioral risk factors (including smoking, poor diet and physical inactivity), so effective behavior change interventions are needed to improve population health. However, uptake and impact of these interventions is limited by methodological challenges. We aimed to identify and achieve consensus on priorities for methodological research in behavioral trials in health research among an international behavioral science community. Methods An international, Delphi consensus study was conducted. Fifteen core members of the International Behavioral Trials Network (IBTN) were invited to generate methodological items that they consider important. From these, the research team agreed a “long-list” of unique items. Two online surveys were administered to IBTN members (N = 306). Respondents rated the importance of items on a 9-point scale, and ranked their “top-five” priorities. In the second survey, respondents received feedback on others’ responses, before rerating items and re-selecting their top five. Results Nine experts generated 144 items, which were condensed to a long-list of 33 items. The four most highly endorsed items, in both surveys 1 (n = 77) and 2 (n = 57), came from two thematic categories:“Intervention development” (“Specifying intervention components” and “Tailoring interventions to specific populations and contexts”) and “Implementation” (“How to disseminate behavioral trial research findings to increase implementation” and “Methods for ensuring that behavioral interventions are implementable into practice and policy”). “Development of novel research designs to test behavioral interventions” also emerged as a highly ranked research priority. Conclusions From a wide array of identified methodological issues, intervention development, implementation and novel research designs are key themes to drive the future behavioral trials’ research agenda. Funding bodies should prioritize these issues in resource allocation.
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Affiliation(s)
- Molly Byrne
- Health Behavior Change Research Group, School of Psychology, National University of Ireland, Galway, H91 TK33, Ireland.
| | - Jenny McSharry
- Health Behavior Change Research Group, School of Psychology, National University of Ireland, Galway, H91 TK33, Ireland
| | - Oonagh Meade
- Health Behavior Change Research Group, School of Psychology, National University of Ireland, Galway, H91 TK33, Ireland
| | - Kim L Lavoie
- Department of Psychology, University of Quebec at Montreal, Montreal, QC, Canada.,Montreal Behavioral Medicine Centre, CIUSSS-NIM - Hôpital du Sacre-Coeur de Montreal, Montreal, QC, Canada
| | - Simon L Bacon
- Montreal Behavioral Medicine Centre, CIUSSS-NIM - Hôpital du Sacre-Coeur de Montreal, Montreal, QC, Canada.,Department of Health, Kinesiology, and Applied Physiology, Concordia University, Montreal, QC, H4B 1R6, Canada
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12
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Biesty L, Galvin S, Finucane E, Healy P, Devane D, Conway T. Can learning about trials be child's play? A qualitative exploration of the 'Schools Teaching Awareness of Randomised Trials' (START) initiative. Trials 2020; 21:208. [PMID: 32075675 PMCID: PMC7031984 DOI: 10.1186/s13063-020-4130-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 02/01/2020] [Indexed: 11/10/2022] Open
Abstract
Background The Health Research Board-Trials Methodology Research Network (HRB-TMRN) celebrates International Clinical Trials Day with the help of the younger members of our community through the Network’s ‘Schools Teaching Awareness of Randomised Trials (START)’ initiative. START seeks to increase public awareness of randomised trials in Ireland. Launched in 2016, it asks children (8–12 years old) to conduct and report their very own fun randomised trial. The study reported in this paper sought to explore children and teachers perceptions and experiences of the START initiative. Methods We conducted eight, one-to one interviews with teachers and eight focus groups with 61 children who took part in the 2018 START initiative. Interviews and focus groups were recorded and transcribed and the data analysed using template analysis. Results The findings of this study highlight the benefits of participating in START and the areas of the initiative that required further attention. Teachers and children recalled the benefits of experiential learning associated with START and learning by doing encouraged a fun way of engaging with trial processes. By recalling all aspects of planning, conducting and reporting their trial, the children in this study demonstrated their awareness of the trial processes. The teachers suggested that START provides a valuable framework to contribute to key aspects of the primary school curriculum in Ireland. The experiences of these participants also provided recommendation for improving the programme for future START participants. Conclusions Increasing public awareness and understanding of randomised trials can help increase public engagement in trials. By educating children about the importance of trials and supporting them to ‘learn by doing’ by carrying out their own trial, the START initiative can contribute substantially to children’s awareness and understanding of trial processes. Given that children are the public, the patients and the researchers of the future, initiatives such as START deserve attention.
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Affiliation(s)
- Linda Biesty
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.
| | - Sandra Galvin
- Health Research Board - Trials Methodology Research Network, National University of Ireland Galway, Galway, Ireland
| | - Elaine Finucane
- Health Research Board - Trials Methodology Research Network, National University of Ireland Galway, Galway, Ireland
| | - Patricia Healy
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland
| | - Declan Devane
- School of Nursing and Midwifery, National University of Ireland Galway, Galway, Ireland.,Health Research Board - Trials Methodology Research Network, National University of Ireland Galway, Galway, Ireland.,Evidence Synthesis Ireland, University Road, Galway, Ireland.,Cochrane Ireland, Galway, Ireland
| | - Tom Conway
- Health Research Board - Clinical Research Facility Galway, National University of Ireland Galway, Galway, Ireland
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13
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Rosala-Hallas A, Gamble C, Blazeby J, Williamson PR. A review of current practice in the design and assessment of internal pilots in UK NIHR clinical trials. Trials 2019; 20:571. [PMID: 31533775 PMCID: PMC6751663 DOI: 10.1186/s13063-019-3669-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 08/20/2019] [Indexed: 11/10/2022] Open
Abstract
Background Internal pilots provide useful information which can help to optimise the running of the main trial. Although some recommendations exist in the literature for the design of internal pilots, little is known about current practice in terms of the specification and also the assessment of progression criteria. The aim of the review is to provide an overview of current practice. Methods A cohort of clinical trials with an internal pilot, funded by the National Institute for Health Research (NIHR), Health Technology Assessment programme (HTA), extracted in 2017 was reviewed. Data were extracted from: project descriptions; summary of changes from the first stage; feedback about the full application; monitoring notes; progress report history and protocols, for information about the design and assessment of internal pilots. Results Fifty-seven studies were reviewed. An internal pilot was first proposed in the early stages of the trial in the majority of cases. Target number for recruitment, rate of randomisation, retention/primary outcome ascertainment rate, rate of treatment adherence and consent rate were included as progression criteria. All but one study was permitted to continue to the main trial; however, 25% did not strictly meet the progression criteria. Changes were made to the design of the main trial for 25% of studies, mainly in terms of conduct of recruitment. Conclusions This review provides insight into the process of designing and assessing internal pilots. Progression criteria are sometimes not met; however, committees involved in the reviewing process will recommend continuation to the main trial, usually accompanied by a second review or close monitoring. Recommendations are made to optimise the process. Electronic supplementary material The online version of this article (10.1186/s13063-019-3669-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Anna Rosala-Hallas
- Clinical Trials Research Centre, University of Liverpool, a member of Liverpool Health Partners, Liverpool, UK.
| | - Carrol Gamble
- Clinical Trials Research Centre, University of Liverpool, a member of Liverpool Health Partners, Liverpool, UK
| | - Jane Blazeby
- Medical Research Council ConDuCT II Hub for Trials Methodology Research, NIHR Bristol Biomedical Research Centres, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Paula R Williamson
- Medical Research Council North West Hub for Trials Methodology Research/Clinical Trials Research Centre, University of Liverpool, a member of Liverpool Health Partners, Liverpool, UK
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14
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Sivell S, Prout H, Hopewell-Kelly N, Baillie J, Byrne A, Edwards M, Harrop E, Noble S, Sampson C, Nelson A. Considerations and recommendations for conducting qualitative research interviews with palliative and end-of-life care patients in the home setting: a consensus paper. BMJ Support Palliat Care 2019; 9:e14. [PMID: 26647042 PMCID: PMC6579488 DOI: 10.1136/bmjspcare-2015-000892] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 09/10/2015] [Accepted: 10/07/2015] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To present and discuss the views of researchers at an academic palliative care research centre on research encounters with terminally ill patients in the home setting and to generate a list of recommendations for qualitative researchers working in palliative and end-of-life care. METHODS Eight researchers took part in a consensus meeting to discuss their experiences of undertaking qualitative interviews. The researchers were of varying backgrounds and all reported having experience in interviewing terminally ill patients, and all but one had experience of interviewing patients in their home environment. RESULTS The main areas discussed by researchers included: whether participation in end-of-life research unintentionally becomes a therapeutic experience or an ethical concern; power relationships between terminally ill patients and researchers; researcher reflexivity and reciprocity; researchers' training needs. Qualitative methods can complement the home environment; however, it can raise ethical and practical challenges, which can be more acute in the case of research undertaken with palliative and patients at the end-of-life. CONCLUSIONS The ethical and practical challenges researchers face in this context has the potential to place both participant and researcher at risk for their physical and psychological well-being. We present a set of recommendations for researchers to consider prior to embarking on qualitative research in this context and advocate researchers in this field carefully consider the issues presented on a study-by-study basis.
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Affiliation(s)
- Stephanie Sivell
- Marie Curie Palliative Care Research Centre, Institute of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, Wales, UK
| | - Hayley Prout
- Marie Curie Palliative Care Research Centre, Institute of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, Wales, UK
| | - Noreen Hopewell-Kelly
- Marie Curie Palliative Care Research Centre, Institute of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, Wales, UK
| | - Jessica Baillie
- School of Healthcare Sciences, Cardiff University, Cardiff, Wales, UK
| | - Anthony Byrne
- Marie Curie Palliative Care Research Centre, Institute of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, Wales, UK
| | - Michelle Edwards
- Centre for Innovative Ageing, College of Human and Health Sciences, Swansea University, Swansea, UK
| | - Emily Harrop
- Marie Curie Palliative Care Research Centre, Institute of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, Wales, UK
| | - Simon Noble
- Marie Curie Palliative Care Research Centre, Institute of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, Wales, UK
| | - Catherine Sampson
- Marie Curie Palliative Care Research Centre, Institute of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, Wales, UK
| | - Annmarie Nelson
- Marie Curie Palliative Care Research Centre, Institute of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, Wales, UK
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15
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Randall S, Brown A, Boyd J, Schnell R, Borgs C, Ferrante A. Sociodemographic differences in linkage error: an examination of four large-scale datasets. BMC Health Serv Res 2018; 18:678. [PMID: 30176856 PMCID: PMC6122711 DOI: 10.1186/s12913-018-3495-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 08/24/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Record linkage is an important tool for epidemiologists and health planners. Record linkage studies will generally contain some level of residual record linkage error, where individual records are either incorrectly marked as belonging to the same individual, or incorrectly marked as belonging to separate individuals. A key question is whether errors in linkage quality are distributed evenly throughout the population, or whether certain subgroups will exhibit higher rates of error. Previous investigations of this issue have typically compared linked and un-linked records, which can conflate bias caused by record linkage error, with bias caused by missing records (data capture errors). METHODS Four large administrative datasets were individually de-duplicated, with results compared to an available 'gold-standard' benchmark, allowing us to avoid methodological issues with comparing linked and un-linked records. Results were compared by gender, age, geographic remoteness (major cities, regional or remote) and socioeconomic status. RESULTS Results varied between datasets, and by sociodemographic characteristic. The most consistent findings were worse linkage quality for younger individuals (seen in all four datasets) and worse linkage quality for those living in remote areas (seen in three of four datasets). The linkage quality within sociodemographic categories varied between datasets, with the associations with linkage error reversed across different datasets due to quirks of the specific data collection mechanisms and data sharing practices. CONCLUSIONS These results suggest caution should be taken both when linking younger individuals and those in remote areas, and when analysing linked data from these subgroups. Further research is required to determine the ramifications of worse linkage quality in these subpopulations on research outcomes.
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Affiliation(s)
- Sean Randall
- Centre for Data Linkage, Curtin University, Perth, 6849, Western Australia.
| | - Adrian Brown
- Centre for Data Linkage, Curtin University, Perth, 6849, Western Australia
| | - James Boyd
- Centre for Data Linkage, Curtin University, Perth, 6849, Western Australia
| | - Rainer Schnell
- German Record Linkage Center, University of Duisburg-Essen, D-47057, Duisburg, Germany
| | - Christian Borgs
- German Record Linkage Center, University of Duisburg-Essen, D-47057, Duisburg, Germany
| | - Anna Ferrante
- Centre for Data Linkage, Curtin University, Perth, 6849, Western Australia
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16
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Abstract
The assessment of content validity is a critical and complex step in the development process of instruments which are frequently used to measure complex constructs in social and administrative pharmacy research. The aims of this study were to investigate the elements of content validity; to describe a practical approach for assessing content validity; and to discuss existing content validity indices. This is a narrative review of the assessment and quantification of content validity. It describes the key stages of conducting the content validation study and discusses the quantification and evaluation of the content validity estimates. Content validity provides evidence about the degree to which elements of an assessment instrument are relevant to and representative of the targeted construct for a particular assessment purpose. The assessment of content validity relies on using a panel of experts to evaluate instrument elements and rate them based on their relevance and representativeness to the content domain. It is a three-stage process that includes; the development stage, judgment and quantifying stage, and revising and reconstruction stage. To quantify the expert judgments, several indices have been discussed in this paper such as the content validity ratio (CVR), content validity index (CVI), modified-Kappa, and some agreement indices. A practical guide describes the process of content validity evaluation is provided. In summary, content validation processes and content validity indices are essential factors in the instrument development process, should be treated and reported as important as other types of construct validation. Determining item CVI and reporting an overall CVI are important components necessary to instruments especially when the instrument is used to measure health outcomes or to guide a clinical decision making. Content validity deserves a rigorous assessment process as the obtained information from this process are invaluable for the quality of the newly developed instrument.
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Affiliation(s)
- Enas Almanasreh
- Sydney Pharmacy School, N511, Pharmacy and Bank Building A15, The University of Sydney, 2006, NSW, Australia.
| | - Rebekah Moles
- Sydney Pharmacy School, N511, Pharmacy and Bank Building A15, The University of Sydney, 2006, NSW, Australia.
| | - Timothy F Chen
- Sydney Pharmacy School, N511, Pharmacy and Bank Building A15, The University of Sydney, 2006, NSW, Australia.
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17
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Walker S, Gibbins J, Paes P, Barclay S, Adams A, Chandratilake M, Gishen F, Lodge P, Wee B. Preparing future doctors for palliative care: views of course organisers. BMJ Support Palliat Care 2017; 8:299-306. [PMID: 28432089 DOI: 10.1136/bmjspcare-2017-001319] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 03/14/2017] [Accepted: 04/05/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND Effective training at medical school is essential to prepare new doctors to safely manage patients with palliative care (PC) and end of life care (EOLC) needs. The contribution of undergraduate PC course organisers is central but their collective views regarding role are unknown. OBJECTIVE To survey attitudes of PC course organisers regarding their course, organisation, the adequacy of training provided and level of personal satisfaction. METHODS An anonymised, multifactorial, web-based questionnaire was devised, tested, modified and then sent to lead PC course organisers at all UK medical schools. RESULTS Data were obtained from all 30 UK medical schools. Organisers agreed/strongly agreed (=agreed) that their PC course was highly rated by students (26, 87%). 25 (83%) agreed their course 'enabled misconceptions and fears about PC, death, dying and bereavement to be addressed', 'delivered quality PC training' (23, 77%), 'fulfilled General Medical Council requirements' (19, 63%), 'prepared students well to care for patients with PC/EOLC needs' (18, 60%) and 'enabled students to visit a hospice and see the role of doctors in caring for the dying' (17, 57%). Concerns were limited capacity to accommodate students (agreed 20, 66%) and variability in teaching according to location (15, 50%). Most agreed their institution recognised PC training as important (22, 73%), they felt supported by colleagues (21, 70%) and experienced cooperation between stakeholders (20, 67%). All agreed that PC training was essential for undergraduates, while 29 (97%) supported inclusion of a hospice visit in the curriculum. 27 agreed that their role was satisfying (90%), 3 disagreed (10%). CONCLUSIONS Approximately two-thirds of organisers were generally positive about their PC course, institution and role. A minority expressed concerns; these may reflect suboptimal PC training at their medical school and poor preparation of new doctors.
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Affiliation(s)
- Steven Walker
- Marie Curie Hospice, Hampstead, London, UK.,Centre for Medical Education, University of Dundee, UK.,Stgilesmedical, London, UK
| | - Jane Gibbins
- Cornwall Hospice Care, Royal Cornwall Hospital, Truro & Peninsula Medical School, UK
| | - Paul Paes
- Northumbria Healthcare NHS Foundation Trust & Newcastle University, Newcastle, UK
| | | | - Astrid Adams
- Sir Michael Sobell House & University of Oxford, Oxford, UK
| | - Madawa Chandratilake
- Centre for Medical Education, University of Dundee, UK.,Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - Faye Gishen
- Marie Curie Hospice, Hampstead, London, UK.,University College London & Royal Free Hospital, London, UK
| | - Philip Lodge
- Marie Curie Hospice, Hampstead, London, UK.,University College London & Royal Free Hospital, London, UK
| | - Bee Wee
- Sir Michael Sobell House & University of Oxford, Oxford, UK
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18
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McLean S, Lennon P, Glare P. Internet search query analysis can be used to demonstrate the rapidly increasing public awareness of palliative care in the USA. BMJ Support Palliat Care 2017. [PMID: 28130324 DOI: 10.1136/bmjspcare‐2016‐001171] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND A lack of public awareness of palliative care (PC) has been identified as one of the main barriers to appropriate PC access. Internet search query analysis is a novel methodology, which has been effectively used in surveillance of infectious diseases, and can be used to monitor public awareness of health-related topics. OBJECTIVES We aimed to demonstrate the utility of internet search query analysis to evaluate changes in public awareness of PC in the USA between 2005 and 2015. METHODS Google Trends provides a referenced score for the popularity of a search term, for defined regions over defined time periods. The popularity of the search term 'palliative care' was measured monthly between 1/1/2005 and 31/12/2015 in the USA and in the UK. RESULTS Results were analysed using independent t-tests and joinpoint analysis. The mean monthly popularity of the search term increased between 2008-2009 (p<0.001), 2011-2012 (p<0.001), 2013-2014 (p=0.004) and 2014-2015 (p=0.002) in the USA. Joinpoint analysis was used to evaluate the monthly percentage change (MPC) in the popularity of the search term. In the USA, the MPC increase was 0.6%/month (p<0.05); in the UK the MPC of 0.05% was non-significant. DISCUSSION Although internet search query surveillance is a novel methodology, it is freely accessible and has significant potential to monitor health-seeking behaviour among the public. PC is rapidly growing in the USA, and the rapidly increasing public awareness of PC as demonstrated in this study, in comparison with the UK, where PC is relatively well established is encouraging in increasingly ensuring appropriate PC access for all.
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Affiliation(s)
- Sarah McLean
- Department of Palliative Medicine, Memorial Sloan Kettering Cancer Center, Zuckermann Research Center, New York, New York, USA
| | - Paul Lennon
- The Head and Neck Service of the Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Paul Glare
- Department of Palliative Medicine, Memorial Sloan Kettering Cancer Center, Zuckermann Research Center, New York, New York, USA
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19
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McLean S, Lennon P, Glare P. Internet search query analysis can be used to demonstrate the rapidly increasing public awareness of palliative care in the USA. BMJ Support Palliat Care 2017; 9:40-44. [PMID: 28130324 DOI: 10.1136/bmjspcare-2016-001171] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 09/22/2016] [Accepted: 01/04/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND A lack of public awareness of palliative care (PC) has been identified as one of the main barriers to appropriate PC access. Internet search query analysis is a novel methodology, which has been effectively used in surveillance of infectious diseases, and can be used to monitor public awareness of health-related topics. OBJECTIVES We aimed to demonstrate the utility of internet search query analysis to evaluate changes in public awareness of PC in the USA between 2005 and 2015. METHODS Google Trends provides a referenced score for the popularity of a search term, for defined regions over defined time periods. The popularity of the search term 'palliative care' was measured monthly between 1/1/2005 and 31/12/2015 in the USA and in the UK. RESULTS Results were analysed using independent t-tests and joinpoint analysis. The mean monthly popularity of the search term increased between 2008-2009 (p<0.001), 2011-2012 (p<0.001), 2013-2014 (p=0.004) and 2014-2015 (p=0.002) in the USA. Joinpoint analysis was used to evaluate the monthly percentage change (MPC) in the popularity of the search term. In the USA, the MPC increase was 0.6%/month (p<0.05); in the UK the MPC of 0.05% was non-significant. DISCUSSION Although internet search query surveillance is a novel methodology, it is freely accessible and has significant potential to monitor health-seeking behaviour among the public. PC is rapidly growing in the USA, and the rapidly increasing public awareness of PC as demonstrated in this study, in comparison with the UK, where PC is relatively well established is encouraging in increasingly ensuring appropriate PC access for all.
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Affiliation(s)
- Sarah McLean
- Department of Palliative Medicine, Memorial Sloan Kettering Cancer Center, Zuckermann Research Center, New York, New York, USA
| | - Paul Lennon
- The Head and Neck Service of the Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Paul Glare
- Department of Palliative Medicine, Memorial Sloan Kettering Cancer Center, Zuckermann Research Center, New York, New York, USA
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20
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Kleinpell R, Vasilevskis EE, Fogg L, Ely EW. Exploring the association of hospice care on patient experience and outcomes of care. BMJ Support Palliat Care 2016; 9:e13. [PMID: 27531840 DOI: 10.1136/bmjspcare-2015-001001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2015] [Revised: 07/08/2016] [Accepted: 07/25/2016] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To examine the association of the use of hospice care on patient experience and outcomes of care. Promoting high-value, safe and effective care is an international healthcare imperative. However, the extent to which hospice care may improve the value of care is not well characterised. METHODS A secondary analysis of variations in care was conducted using the Dartmouth Atlas Report, matched to the American Hospital Association Annual Survey Database to abstract organisational characteristics for 236 US hospitals to examine the relationship between hospice usage and a number of variables that represent care value, including hospital care intensity index, hospital deaths, intensive care unit (ICU) deaths, patient satisfaction and a number of patient quality indicators. Structural equation modelling was used to demonstrate the effect of hospice use on patient experience, clinical and efficiency outcomes. RESULTS Hospice admissions in the last 6 months of life were correlated with a number of variables, including increases in patient satisfaction ratings (r=0.448, p=0.01) and better pain control (r=0.491, p=0.01), and reductions in hospital days (r=-0.517, p=0.01), fewer hospital deaths (r=-0.842, p=0.01) and fewer deaths occurring with an ICU admission during hospitalisation (r=-0.358, p=0.01). The structural equation model identified that use of hospice care was inversely related to hospital mortality (-0.885) and ICU mortality (-0.457). CONCLUSIONS The results of this investigation demonstrate that greater use of hospice care during the last 6 months of life is associated with improved patient experience, including satisfaction and pain control, as well as clinical outcomes of care, including decreased ICU and hospital mortality.
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Affiliation(s)
- Ruth Kleinpell
- Rush University Medical Center and Rush University College of Nursing, Chicago, Illinois, USA
| | - Eduard E Vasilevskis
- Department of Medicine, Vanderbilt University Medical Center, Veteran's Affairs, Tennessee Valley Geriatric Research Education Clinical Center (GRECC), Nashville, Tennessee, USA
| | - Louis Fogg
- Rush University Medical Center and Rush University College of Nursing, Chicago, Illinois, USA
| | - E Wesley Ely
- Department of Medicine, Vanderbilt University Medical Center, Veteran's Affairs, Tennessee Valley Geriatric Research Education Clinical Center (GRECC), Nashville, Tennessee, USA
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21
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Affiliation(s)
- Amara Callistus Nwosu
- Marie Curie Palliative Care Institute Liverpool (MCPCIL), University of Liverpool, Liverpool, UK
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22
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Froggatt K, Preston N, Turner M, Kerr C. Patient and public involvement in research and the Cancer Experiences Collaborative: benefits and challenges. BMJ Support Palliat Care 2014; 5:518-21. [PMID: 24727479 DOI: 10.1136/bmjspcare-2013-000548] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Accepted: 03/25/2014] [Indexed: 11/04/2022]
Abstract
AIMS AND OBJECTIVES The involvement of patients in the design and conduct of research is increasingly promoted by policy and research bodies. The experiences of individuals who become involved in research in this way are not well understood. This study aims to describe the experiences of people's participation in patient and public involvement (PPI) in supportive and palliative care research, specifically with respect to the benefits and challenges of participation for the individuals and the broader research support structures. METHODS In this qualitative exploratory study, semistructured interviews were undertaken with individuals who had a cancer diagnosis and were involved in a supportive and palliative care research collaborative over a period of 6 years. Recruitment was through the host university organisations involved in the research collaborative. A thematic analysis was undertaken to identify commonalities and differences across their experiences. FINDINGS The eight participants in the study were highly motivated and undertook PPI in research alongside other voluntary activities. They identified a number of research and personal benefits: bringing a lay perspective into research, making a difference and personal gains. Personal gains concerned support, new knowledge and skills and greater confidence. The challenges to participation that were identified included the emotional and practical nature of the work, issues of language and identifying the difference made. CONCLUSIONS Involvement in supportive and palliative care research is valued by people with a cancer diagnosis, but there are ongoing issues of emotional support and good communication through the use of appropriate language in documentation.
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Affiliation(s)
- Katherine Froggatt
- International Observatory on End of Life Care, Lancaster University, Lancaster, UK
| | - Nancy Preston
- International Observatory on End of Life Care, Lancaster University, Lancaster, UK
| | - Mary Turner
- International Observatory on End of Life Care, Lancaster University, Lancaster, UK
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23
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Affiliation(s)
- Pål Klepstad
- Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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24
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Pumar-Méndez MJ, Attree M, Wakefield A. Methodological aspects in the assessment of safety culture in the hospital setting: a review of the literature. Nurse Educ Today 2014; 34:162-170. [PMID: 24011753 DOI: 10.1016/j.nedt.2013.08.008] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Revised: 07/04/2013] [Accepted: 08/11/2013] [Indexed: 06/02/2023]
Abstract
A thematic literature review was undertaken to identify methodological aspects in the assessment of safety culture and critically examine how these have been addressed in hospital-based studies of safety culture, for the period 1999-2012. The literature search included an electronic database search (BNI, CINAHL, EMBASE, MEDLINE and PsycINFO), access to websites of organizations dedicated to the enhancement of patient safety, and a manual search of reference lists of the papers included. The analysis of the 43 records included in the review revealed that discussion regarding the measurement of safety culture in the hospital setting revolves around three methodological areas, namely: research approaches; survey tools for data collection; and levels of data aggregation. To advance these discussions, robust research is needed to clarify what dimensions belong to the core of safety culture and what the main sources of safety culture variability are. Studies using a mixed methods approach to assess safety culture would be useful, since they permit the in-depth research necessary to depict the multiple components of this construct.
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Affiliation(s)
- María J Pumar-Méndez
- Dpto. Enfermería Comunitaria y Materno-Infantil, Room S.090, Los Castaños building, Universidad de Navarra, C/Irunlarrea, 1, 31008 Pamplona, Spain.
| | - Moira Attree
- The School of Nursing, Midwifery and Social Work, The University of Manchester, Room 5.343, Jean McFarlane Building, University Place, Oxford Road, Manchester M13 9PL, United Kingdom.
| | - Ann Wakefield
- The School of Nursing, Midwifery and Social Work, The University of Manchester, Room 5.326, Jean McFarlane Building, University Place, Oxford Road, Manchester M13 9PL, United Kingdom.
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Addington-Hall J, Hunt K, Rowsell A, Heal R, Hansford P, Monroe B, Sykes N. Development and initial validation of a new outcome measure for hospice and palliative care: the St Christopher's Index of Patient Priorities (SKIPP). BMJ Support Palliat Care 2013; 4:175-181. [PMID: 24644169 DOI: 10.1136/bmjspcare-2012-000352] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Revised: 06/27/2013] [Accepted: 08/16/2013] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To develop and conduct a preliminary psychometric analysis of a hospice and palliative care patient-reported outcome measure to detect patients' perceptions of change in quality of life (QoL) and issues of concern, and views of service benefit. METHODS Following pilot testing and cognitive interviewing, St Christopher's Index of Patient Priorities (SKIPP) was administered twice to hospice inpatients and homecare patients. QoL was rated 'now', and retrospectively 'before starting hospice care' or 'at the time of the first interview'. Patients nominated and rated progress with main concerns, rated the difference the service was making, and completed palliative care outcome scale. Patients completed SKIPP again within 24 h to measure test-retest reliability. RESULTS QoL scores 'now' differed significantly from retrospective scores made at same time: QoL increased with hospice care when patients 'looked back' on previous QoL. Four-fifths reported that their first concern had got 'a little'/ 'much' better since initial service contact: this declined subsequently. Four-fifths at both time points said the hospice had made 'a lot of difference' to them. No significant differences were noted between time points on palliative care outcome scale items. Test-retest analyses were prevented by low numbers. CONCLUSIONS SKIPP can detect patients' perception of change in QoL and main concerns, and the difference patients think the service has made to them. Its design with current and retrospective components addresses response shift and means it can be used for quality improvement or clinical purposes with only one administration, an advantage in frail populations. It is therefore a useful addition to hospice and palliative care patient-reported outcome measures.
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Affiliation(s)
| | - Katherine Hunt
- Faculty of Health Sciences, University of Southampton, Southampton, UK
| | - Ali Rowsell
- Faculty of Health Sciences, University of Southampton, Southampton, UK
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Rhondali W, Berthiller J, Hui D, Yennu S, Lafumas V, Ledoux M, Strasser F, Filbet M. Barriers to research in palliative care in France. BMJ Support Palliat Care 2013; 4:182-189. [PMID: 24644171 DOI: 10.1136/bmjspcare-2012-000360] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 02/20/2013] [Accepted: 03/13/2013] [Indexed: 11/04/2022]
Abstract
PURPOSE Palliative care (PC) needs expansion of its research capacity to improve the quality of care. This is particularly true for France that contributed less than 2% of all European PC research publications. We conducted a survey to assess the barriers French healthcare professionals (HCPs) involved in PC research had to face. METHODS We surveyed all 420 PC departments registered in the French National Association for Palliative Care (SFAP) database using a previously used questionnaire. We documented the ethical limitations, time constraints, financial resources, patient issues and methodological issues related to PC research. RESULTS We obtained 382 responses. Ninety-two (24.1%) HCPs were involved in a research project during the last 5 years. In univariate results, predictors of being involved in PC research were men (p=0.004), physician (p=0.022), working at a university hospital (p<0.001). There was a trend towards working in a PC unit (p=0.052). The main barriers to participating in PC research were lack of time (80.1%) and patient issues (47.4%). Lack of methodological support (33.0%) and financial limitations (30.4%) were also reported as major barriers. CONCLUSIONS There is a consensus that PC research and publication in the English language for peer-reviewed journals must be expanded in France but at this stage, clinical teams still lack specific funding and appropriate support. More research is needed to confirm our results and to determine the best ways to develop PC research capacity in France.
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Affiliation(s)
- Wadih Rhondali
- Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Lyon, France.,Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Julien Berthiller
- Pole Information Médicale Evaluation Recherche, Hospices Civils de Lyon, Lyon, France
| | - David Hui
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Sriram Yennu
- Department of Palliative Care and Rehabilitation Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Veronique Lafumas
- Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Lyon, France
| | - Mathilde Ledoux
- Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Lyon, France
| | - Florian Strasser
- Oncological Palliative Medicine, Department of Internal Medicine and Palliative Care Center, Cantonal Hospital, St Gallen, Switzerland
| | - Marilène Filbet
- Department of Palliative Care, Centre Hospitalier de Lyon-Sud, Hospices Civils de Lyon, Lyon, France
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