Listed in Issue 172


DOWNEY and COLLEAGUES,  Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, Washington 98195, USA.  researched the effects of massage and meditation upon patient benefit and quality of life.


Improving end-of-life care is a priority in the United States, but assigning priorities for standard care services requires evaluations using appropriate study design and appropriate outcome indicators.


A recent randomized controlled trial with terminally ill patients produced no evidence of benefit from massage or guided meditation, when evaluated with measures of global quality of life or pain distress over the course of patient participation.


However, reanalysis using a more targeted outcome, surrogates' assessment of patients' benefit from the study intervention, suggested significant gains from massage - the treatment patients gave their highest pre-assignment preference ratings.


The authors conclude that adding a menu of complementary therapies as part of standard end-of-life care may yield significant benefit, that patient preference is an important predictor of outcome, and that modifications in trial design may be appropriate for end-of-life studies.


Downey L, Engelberg RA, Standish LJ, Kozak L and Lafferty WE. Three lessons from a randomized trial of massage and meditation at end of life: patient benefit, outcome measure selection, and design of trials with terminally ill patients. American Journal of Hospice & Palliative Medicine 26(4): 246-53, Aug-Sep 2009.


The above research strategy, i.e. to refine and reanalyse results of a randomized control trial to take note of patient and carer's preferences to treatment for end-of-life studies, demonstrates that it is possible to derive a more refined and accurate result from research conducted in this are.

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