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Palliative Medicine The Research Journal of the EAPC
Article Reviews
| Issue |
Article Reference |
Reviewer
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| 2004 18(1): |
M Piggott, H McGee, D Feuer : Has CONFORT improved the reporting of randomized controlled trials in the palliative care literature? A systematic review.
Palliative Medicine 2004; 18: 32-38 |
Stein Kaasa , Trondheim, Norway |
| Background |
The journal “Palliative Medicine” is improving in quality, at least from my perspective. Professor Hanks has been able to attract high quality papers recently.
Valid research is quality, quality in research proves clinical practice and Evidence Based Medicine (EBM) should as much as possible be the fundament of a clinical decision making in medicine in general, as well as in palliative care.
Consolidated Standards of Reporting Trials (CONSORT) was produced in 1996 in order to improve the reporting of clinical trials. Inadequate attention to random allocation, allocation concealment, blinding and intention to treat can lead to bias in clinical trials. In order to make judgements easier the CONSORT standards were developed.
The CONSORT statement has been adopted by a number of leading medical journals, the aim of the present study was to assess the quality of the reporting of RCTs in the specialist palliative care literature.
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| Clinical Aspects |
| Results: The combined search strategies found there to be a total of 93 RCTs from 1984 to 2000. The numbers of RCTs reported increased over the three time cohort, 1986-90: nine trials, 1991-95: 37 trials and 1996-2000: 47 trials. More trials were looking at pain than at other aspects of palliative care (59 versus 34). |
| Methods and study design |
| All RCTs found in three specialist palliative care journal from 1986 to the end of 2000 were included, i.e. Palliative Medicine, Journal of Pain and Symptom Management and American Journal of Hospice and Palliative Care. First, The Cochrane Controlled Trials Register was searched for all RCTs in palliative care, and then the list was supplemented by hand searching all the relevant journals. Acceptable methods of randomisation and allocation concealment were taken from the Cochrane Collaboration Handbook. Two investigators read all the studies and each independently completed the checklist. The trials were divided into three time cohorts of five years (1986-90, 1991-95 and 1996-2000). |
| Comments/ Suggestions for further development / Open Questions |
| Medicine in general and palliative care particularly are in need of more well conducted clinical trials. In many situations trials are undersized, i.e. the chance of misleading results is evident. Furthermore, it is very encouraging to see that the number of trials have increased for the three time cohorts investigated. This study highlights the present deficiencies, however it also shows the improvement of both quality and quantity in controlled clinical trials in palliative care. There is evidence that CONSORT has lead to an improvement in quality of trial reporting, and undoubtedly more palliative care journals should adapt to this standard. |
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