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Cited by 95Palliative Care and End-of-Life IssuesMeta-analysis and systematic reviewsPalliative and Oncologic Care

Clinical trials in palliative care: a systematic review of their methodological characteristics and of the quality of their reporting

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Bouça-Machado, Raquel, Rosário, Madalena, Alarcão, Joana, Correia-Guedes, Leonor, Abreu, Daisy, Ferreira, Joaquim J.·2017·BMC Palliative Care
DOI 10.1186/s12904-016-0181-9PMC PMC5264484
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Abstract

BACKGROUND: Over the past decades there has been a significant increase in the number of published clinical trials in palliative care. However, empirical evidence suggests that there are methodological problems in the design and conduct of studies, which raises questions about the validity and generalisability of the results and of the strength of the available evidence. We sought to evaluate the methodological characteristics and assess the quality of reporting of clinical trials in palliative care. METHODS: We performed a systematic review of published clinical trials assessing therapeutic interventions in palliative care. Trials were identified using MEDLINE (from its inception to February 2015). We assessed methodological characteristics and describe the quality of reporting using the Cochrane Risk of Bias tool. RESULTS: We retrieved 107 studies. The most common medical field studied was oncology, and 43.9% of trials evaluated pharmacological interventions. Symptom control and physical dimensions (e.g. intervention on pain, breathlessness, nausea) were the palliative care-specific issues most studied. We found under-reporting of key information in particular on random sequence generation, allocation concealment, and blinding. CONCLUSIONS: While the number of clinical trials in palliative care has increased over time, methodological quality remains suboptimal. This compromises the quality of studies. Therefore, a greater effort is needed to enable the appropriate performance of future studies and increase the robustness of evidence-based medicine in this important field.

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  • In a multicenter trial, withdrawal of statins among people with diabetes in palliative care was found to improve quality of life.

    “In a multicenter trial, withdrawal of statins among people with diabetes in palliative care was found to improve quality of life (131-133).”

    From 13. Older Adults: <i>Standards of Care in Diabetes—2024</i> (2024) · cites this paper as [133]

    The Results section on outcomes and assessment tools reports how often palliative-care trials measured quality of life, but does not report an effect of statin withdrawal. Searches for statins, discontinuation, diabetes, and a multicenter trial found no passage in our copy addressing the claimed finding; page numbers were not provided. (LLM, conf=0.72)

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  • In a multicenter trial, withdrawal of statins among people with diabetes in palliative care was found to improve quality of life.

    “In a multicenter trial, withdrawal of statins among people with diabetes in palliative care was found to improve quality of life (150-152).”

    From 13. Older Adults: Standards of Care in Diabetes—2025 (2025) · cites this paper as [152]

    The Results (Types of interventions) and Discussion (What interventions?) describe categories of palliative-care trials, not the outcome of a statin-withdrawal trial. Searches for statins, diabetes, and quality-of-life improvement after withdrawal found no passage addressing the claimed multicenter finding. Page numbers were not available in our copy. (LLM, conf=0.76)

    Experimental — accuracy not yet measured

  • In a multicenter trial, withdrawal of statins among people with diabetes in palliative care was found to improve quality of life.

    “In a multicenter trial, withdrawal of statins among people with diabetes in palliative care was found to improve quality of life (171–173).”

    From 13. Older Adults: Standards of Care in Diabetes—2026 (2026) · cites this paper as [173]

    The Results (Types of interventions; Outcomes and assessment tools; pages unavailable) summarize palliative-care trials and quality-of-life outcomes, but do not report a multicenter statin-withdrawal trial or its findings. Searches for statins, diabetes, and improved quality of life after stopping lipid-lowering therapy found no passage addressing the claim. (LLM, conf=0.76)

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Cited by

Sorted by citations

Authors
Bouça-Machado, R., Rosário, M., Alarcão, J., Correia-Guedes, L., Abreu, D., & Ferreira, J. J.
Affiliations
University of Lisbon (PT)
Corresponding author
Ferreira, Joaquim J.
ORCID
Venue
BMC Palliative Care
Publisher
Springer Science and Business Media LLC
Published
2017-01-25
Volume
16
Issue
1
Pages
10-10
ISSN
1472-684X (ISSN-L)
DOI
10.1186/s12904-016-0181-9
PMC
PMC5264484
OpenAlex
W2580004407
Cited by
95
References
5
Citations by year
2026: 9 · 2025: 13 · 2024: 18 · 2023: 11 · 2022: 7 · 2021: 11 · 2020: 7 · 2019: 5 · 2018: 9 · 2017: 5
FWCI
1.15
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • BMC Palliative Care (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Portuguese National Funding Agency for Science, Research and Technology (RCAAP Project by FCT) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative Care and End-of-Life Issues
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Palliative and Oncologic Care
Keywords
palliative care, clinical trials, methodological quality, reporting quality, risk of bias, random sequence generation, allocation concealment, blinding, symptom management, evidence-based medicine
MeSH terms
Data Accuracy, Clinical Trials as Topic, Humans, Medicine, Outcome and Process Assessment, Health Care, Palliative Care, Surveys and Questionnaires, Research Design, Sample Size

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