Measuring Goal-Concordant Care in Palliative Care Research.
Measuring Goal-Concordant Care in Palliative Care Research.
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DOI：
10.1016/j.jpainsymman.2021.02.030
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发表时间：
2021-09
影响因子：
4.7
通讯作者：
Hanson, Laura C.
中科院分区：
文献类型：
--
作者：
Ernecoff, Natalie C.;Wessell, Kathryn L.;V. Bennett, Antonia;Hanson, Laura C.
>目标一致的护理是姑息治疗研究的首要成果，但该领域缺乏最佳测量方法的共识。我们试图 1) 对用于衡量目标一致护理的方法进行分类，2) 使用姑息治疗研究的经验例子讨论每种方法的优点和局限性。我们对目标一致护理的测量方法进行了分类。我们确定了每种方法的经验示例，以说明每种方法的优点、局限性以及对相关研究设计的适用性。我们定义了四种用于衡量目标一致性护理的方法：1）患者或护理人员报告，2）护理人员死后报告，3）纵向数据一致性，4）人口水平指标。患者或护理人员报告的目标一致护理借鉴了患者报告结果的优势，并且可以针对治疗的多个方面进行捕获；这些方法容易受到回忆偏差或家庭代理偏差的影响。当治疗偏好可以在时间上与实际治疗具体相关时，纵向数据的一致性是最佳的；该方法仅限于常见的维持生命的治疗选择，有效性可能会受到偏好和治疗之间时间变化的影响。人口层面的指标使务实研究能够涵盖大量人口；其主要局限性在于假设大多数人的偏好应与类似人群的实际待遇模式相对应。用于衡量目标一致护理的方法具有明显的优点和局限性，应根据研究问题和研究设计来选择方法。现有方法可以改进，但未来的黄金标准不太可能适合所有研究设计。 David Casarett，医学博士、马萨诸塞州这篇综述文章总结了衡量目标一致护理的各种方法的已知信息，并确定了应成为未来研究重点的重要差距和问题。
>Goal-concordant care is a priority outcome for palliative care research, yet the field lacks consensus on optimal methods for measurement. We sought to 1) categorize methods used to measure goal-concordant care, and 2) discuss strengths and limitations of each method using empirical examples from palliative care research. We categorized measurement methods for goal-concordant care. We identified empirical examples of each method to illustrate the strengths, limitations, and applicability of each method to relevant study designs. We defined four methods used to measure goal-concordant care: 1) Patient- or Caregiver-Reported, 2) Caregiver-Reported After Death, 3) Concordance in Longitudinal Data, and 4) Population-Level Indicators. Patient or caregiver-reported goal-concordant care draws on strengths of patient-reported outcomes, and can be captured for multiple aspects of treatment; these methods are subject to recall bias or family-proxy bias. Concordance in longitudinal data is optimal when a treatment preference can be specifically and temporally linked to actual treatment; the method is limited to common life-sustaining treatment choices and validity may be affected by temporal variation between preference and treatment. Population-level indicators allow pragmatic research to include large populations; its primary limitation is the assumption that preferences held by a majority of persons should correspond to patterns of actual treatment in similar populations. Methods used to measure goal-concordant care have distinct strengths and limitations, and methods should be selected based on research question and study design. Existing methods could be improved, yet a future gold standard is unlikely to suit all research designs. David Casarett, MD, MA This review article summarizes what is known about various approaches to measuring goal-concordant care, and identifies important gaps and questions that should be the focus of future research.
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影响因子：
3.1
作者：
Gomes B;Calanzani N;Gysels M;Hall S;Higginson IJ
通讯作者：
Higginson IJ
影响因子：
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Fink, Regina M.;Somes, Elizabeth;Lum, Hillary D.
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影响因子：
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Murtagh, Fliss E. M.
影响因子：
39.2
作者：
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通讯作者：
Drickamer, MA
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