Topics in research: structuring studies in palliative care.

PURPOSE OF REVIEW

This review describes the advances in trial methodology and presents new methodologies to meet some of the challenges of conducting trials in a palliative care setting. To describe why this review is timely and relevant.

RECENT FINDINGS

This review discusses the process required to conduct trials of complex interventions described by the Britain's Medical Research Council. It discusses the importance of feasibility trials and the quantitative research inherent in these trials. It describes the design alternatives to the classic randomized controlled trials (RCTs), including cluster randomization, step wedge and fast-track randomization, and n-of-1 trial design. The strengths and weaknesses of each are described.

SUMMARY

An understanding of the limitations of RCTs is important. It is important that clinicians and researchers understand the need for alternative trial design and how and when to use them.