Department of Palliative Care & Rehabilitation Medicine, Unit 008, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030, USA.
Oncologist. 2011;16(5):694-703. doi: 10.1634/theoncologist.2010-0397. Epub 2011 Apr 6.
The current state of the palliative oncology literature is unclear. We examined and compared the quantity, research design, and research topics of palliative oncology publications in the first 6 months of 2004 with the first 6 months of 2009. We systematically searched MEDLINE, PsychInfo, EMBASE, ISI Web of Science, and CINAHL for original studies, review articles, and systematic reviews related to "palliative care" and "cancer" during the first 6 months of 2004 and 2009. Two physicians reviewed the literature independently and coded the study characteristics with high inter-rater reliability. We found a consistent decrease in the proportion of oncology studies related to palliative care between 2004 and 2009, despite an absolute increase in the total number of palliative oncology studies. Combining the two time periods, the most common original study designs were case report/series, cross-sectional studies, and qualitative studies. Randomized controlled trials comprised 6% of all original studies. The most common topics were physical symptoms, health services research, and psychosocial issues. Communication, decision making, spirituality, education, and research methodologies all represented <5% of the literature. Comparing 2004 with 2009, we found an increase in the proportion of original studies among all palliative oncology publications but no significant difference in study design or research topic. We identified significant deficiencies in the quantity, design, and scope of the palliative oncology literature. Further effort and resources are necessary to improve the evidence base for this important field.
目前姑息肿瘤学文献的状况尚不清楚。我们检查并比较了 2004 年上半年和 2009 年上半年发表的姑息肿瘤学出版物的数量、研究设计和研究主题。我们系统地检索了 MEDLINE、PsychInfo、EMBASE、ISI Web of Science 和 CINAHL，以获取与“姑息治疗”和“癌症”相关的原始研究、综述文章和系统评价，检索时间为 2004 年和 2009 年上半年。两位医生独立审查文献，并对研究特征进行了编码，具有很高的组内一致性。我们发现，尽管姑息肿瘤学研究的总数绝对增加，但与姑息治疗相关的肿瘤学研究的比例在 2004 年至 2009 年间持续下降。将两个时期结合起来，最常见的原始研究设计是病例报告/系列、横断面研究和定性研究。随机对照试验占所有原始研究的 6%。最常见的主题是身体症状、卫生服务研究和心理社会问题。沟通、决策、精神、教育和研究方法都占文献的<5%。与 2004 年相比，2009 年所有姑息肿瘤学出版物中的原始研究比例增加，但研究设计或研究主题没有显著差异。我们发现姑息肿瘤学文献在数量、设计和范围方面存在明显不足。需要进一步努力和资源来改善这一重要领域的证据基础。
