Palliative and Supportive Services, Flinders University, Adelaide, South Australia, Australia.
J Pain Symptom Manage. 2012 May;43(5):902-10. doi: 10.1016/j.jpainsymman.2011.05.015. Epub 2012 Mar 21.
In specialist hospice and palliative care services, variations occur in diagnoses and prognoses of subpopulations referred, service configuration, and the health systems delivering care. These three levels of variation limit the ability to generalize study findings.
This article reports on coding one year of palliative care research using a previously developed checklist. The aims were to 1) quantify current reporting of factors related to generalizability in specialist palliative care research; 2) review and potentially refine the checklist in light of the first aim; 3) demonstrate the feasibility of collecting these data; and 4) set out simple processes to aid researchers in reporting, and clinicians in applying, new research evidence in hospice and palliative care.
A previously published checklist (five domains, 14 core subdomains, and 24 noncore subdomains) was used to code all research articles (n=189) published in 2007 in the three leading palliative care research journals.
The most frequently reported subdomains were patient age, gender, and diagnosis; model of service delivery; and patient performance status. Data in subdomains, including time from referral to death, socioeconomic indices, and ethnicity, were rarely reported; none reported whole-of-service or whole-of-population data. In total, 2646 (189×14) core subdomains could have been reported. Data were provided in 28% (746/2646).
Checklists such as the Consolidated Standards of Reporting Trials evaluate study design, focusing mainly on internal validity. The proposed checklist deals with specific content of hospice and palliative care, focusing on external validity.
在专科临终关怀和姑息治疗服务中，转诊人群的诊断和预后、服务配置以及提供护理的卫生系统存在差异。这三个层面的差异限制了研究结果推广的能力。
本文报道了使用先前开发的清单对一年的姑息治疗研究进行编码。目的是：1）量化当前在专科姑息治疗研究中报告与推广性相关的因素；2）根据第一个目标审查和可能完善清单；3）展示收集这些数据的可行性；4）阐明简单的流程，以帮助研究人员报告新的研究证据，并帮助临床医生在临终关怀和姑息治疗中应用新的研究证据。
使用先前发表的清单（五个领域，14 个核心子领域和 24 个非核心子领域）对 2007 年在三个主要姑息治疗研究期刊上发表的所有研究文章（n=189）进行编码。
报告最多的子领域是患者年龄、性别和诊断、服务提供模式和患者表现状态。转诊至死亡时间、社会经济指数和种族等子领域的数据很少报告；没有报告整个服务或整个人群的数据。总共可以报告 2646 个（189×14）核心子领域。仅提供了 28%（746/2646）的数据。
像临床试验的统一报告标准这样的清单评估研究设计，主要侧重于内部有效性。拟议的清单涉及临终关怀和姑息治疗的具体内容，侧重于外部有效性。
