This Article Full Text (PDF) All Versions of this Article: 0269216308098802v1 23/1/23    most recent References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Simon, S Articles by Higginson, I. Search for Related Content PubMed PubMed Citation Articles by Simon, S Articles by Higginson, I. Social Bookmarking                         What's this?

Evaluation of hospital palliative care teams: strengths and weaknesses of the before-after study design and strategies to improve it

Institute of Palliative Care, Oldenburg, Germany; King’s College London, School of Medicine, Department of Palliative Care, Policy and Rehabilitation, London steffen{at}steffensimon.de

IJ Higginson

King’s College London, School of Medicine, Department of Palliative Care, Policy and Rehabilitation, London

Hospital palliative care teams (HPCTs) are well established as multi-professional services to provide palliative care in an acute hospital setting and are increasing in number. However, there is still limited evaluation of them, in terms of efficacy and effectiveness. The gold standard method of evaluation is a randomised control trial, but because of methodological (e.g., randomisation), ethical and practical difficulties such trials are often not possible. HPCT is a complex intervention, and the specific situation in palliative care makes it challenging to evaluate (e.g., distress and cognitive impairment of patients). The quasi-experimental before-after study design has the advantage of enabling an experimental character without randomisation. But this has other weaknesses and is prone to bias, for example, temporal trends and selection bias. As for every study design, avoidance and minimisation of bias is important to improve validity. Therefore, strategies of selecting an appropriate control group or time series and applying valid outcomes and measurement tools help reducing bias and strengthen the methods. Special attention is needed to plan and define the design and applied method.

Key Words: evaluation studies • health service • palliative care • patient care team • research design

This version was published on January 1, 2009

Palliative Medicine, Vol. 23, No. 1, 23-28 (2009)
DOI: 10.1177/0269216308098802


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?