专科姑息治疗的力量：走向系统视角。

The power of specialty palliative care: moving towards a systems perspective.

机构信息

The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Section of Palliative Care, Department of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA; Cancer Population Sciences Program, Norris Cotton Cancer Center, Lebanon, NH, USA.

The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA; Department of Computer Science, Dartmouth College, Hanover, NH, USA; Cancer Population Sciences Program, Norris Cotton Cancer Center, Lebanon, NH, USA.

出版信息

Lancet Haematol. 2021 May;8(5):e376-e381. doi: 10.1016/S2352-3026(21)00099-5.

DOI:10.1016/S2352-3026(21)00099-5

PMID:33894172

Abstract

Three palliative care clinical trials were presented at the 2020 American Society for Clinical Oncology Annual Meeting. The heterogeneity in populations, models of care, study design, and assessment of clinical outcomes across these three studies show the broad opportunities for research into interventions for palliative care. In this Viewpoint, we summarise the characteristics of these studies, discuss their novel features and lingering questions, and offer a suggestion for further expanding the focus of clinical trials for delivery of palliative care in the future. We particularly argue that the propensity to characterise palliative care as if it was a clinical or biomedical intervention hampers the design and evaluation of complex clinical interventions that influence clinicians, systems for health-care delivery, individual patients, and their families.

摘要

在 2020 年美国临床肿瘤学会年会上提出了三项姑息治疗临床试验。这三项研究在人群、护理模式、研究设计和临床结局评估方面存在异质性，这表明姑息治疗干预措施的研究有广泛的机会。在本观点中，我们总结了这些研究的特点，讨论了它们的新颖之处和悬而未决的问题，并为未来进一步扩大姑息治疗临床试验的重点提供了建议。我们特别认为，将姑息治疗描述为临床或生物医学干预的倾向，阻碍了影响临床医生、医疗保健提供系统、个体患者及其家属的复杂临床干预措施的设计和评估。