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The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review

BACKGROUND: Malignant bowel obstruction, a complication of certain advanced cancers, causes severe symptoms which profoundly affect quality of life. Clinical management remains complex, and outcome assessment is inconsistent. AIM: To identify outcomes evaluating palliative treatment for inoperable m...

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Autores principales: Bravington, Alison, Obita, George, Baddeley, Elin, Johnson, Miriam J, Murtagh, Fliss EM, Currow, David C, Boland, Elaine G, Nelson, Annmarie, Seddon, Kathy, Oliver, Alfred, Noble, Simon IR, Boland, Jason W
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10150264/
https://www.ncbi.nlm.nih.gov/pubmed/36131489
http://dx.doi.org/10.1177/02692163221122352
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author Bravington, Alison
Obita, George
Baddeley, Elin
Johnson, Miriam J
Murtagh, Fliss EM
Currow, David C
Boland, Elaine G
Nelson, Annmarie
Seddon, Kathy
Oliver, Alfred
Noble, Simon IR
Boland, Jason W
author_facet Bravington, Alison
Obita, George
Baddeley, Elin
Johnson, Miriam J
Murtagh, Fliss EM
Currow, David C
Boland, Elaine G
Nelson, Annmarie
Seddon, Kathy
Oliver, Alfred
Noble, Simon IR
Boland, Jason W
author_sort Bravington, Alison
collection PubMed
description BACKGROUND: Malignant bowel obstruction, a complication of certain advanced cancers, causes severe symptoms which profoundly affect quality of life. Clinical management remains complex, and outcome assessment is inconsistent. AIM: To identify outcomes evaluating palliative treatment for inoperable malignant bowel obstruction, as part of a four-phase study developing a core outcome set. DESIGN: The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); PROSPERO (ID: CRD42019150648). Eligible studies included at least one subgroup with obstruction below the ligament of Treitz undergoing palliative treatment for inoperable malignant bowel obstruction. Study quality was not assessed because the review does not evaluate efficacy. DATA SOURCES: Medline, Embase, the Cochrane Database, CINAHL, PSYCinfo Caresearch, Open Grey and BASE were searched for trials and observational studies in October 2021. RESULTS: A total of 4769 studies were screened, 290 full texts retrieved and 80 (13,898 participants) included in a narrative synthesis; 343 outcomes were extracted verbatim and pooled into 90 unique terms across six domains: physiological, nutrition, life impact, resource use, mortality and survival. Prevalent outcomes included adverse events (78% of studies), survival (54%), symptom control (39%) and mortality (31%). Key individual symptoms assessed were vomiting (41% of studies), nausea (34%) and pain (33%); 19% of studies assessed quality of life. CONCLUSIONS: Assessment focuses on survival, complications and overall symptom control. There is a need for definitions of treatment ‘success’ that are meaningful to patients, a more consistent approach to symptom assessment, and greater consideration of how to measure wellbeing in this population.
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spelling pubmed-101502642023-05-02 The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review Bravington, Alison Obita, George Baddeley, Elin Johnson, Miriam J Murtagh, Fliss EM Currow, David C Boland, Elaine G Nelson, Annmarie Seddon, Kathy Oliver, Alfred Noble, Simon IR Boland, Jason W Palliat Med Original Articles BACKGROUND: Malignant bowel obstruction, a complication of certain advanced cancers, causes severe symptoms which profoundly affect quality of life. Clinical management remains complex, and outcome assessment is inconsistent. AIM: To identify outcomes evaluating palliative treatment for inoperable malignant bowel obstruction, as part of a four-phase study developing a core outcome set. DESIGN: The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); PROSPERO (ID: CRD42019150648). Eligible studies included at least one subgroup with obstruction below the ligament of Treitz undergoing palliative treatment for inoperable malignant bowel obstruction. Study quality was not assessed because the review does not evaluate efficacy. DATA SOURCES: Medline, Embase, the Cochrane Database, CINAHL, PSYCinfo Caresearch, Open Grey and BASE were searched for trials and observational studies in October 2021. RESULTS: A total of 4769 studies were screened, 290 full texts retrieved and 80 (13,898 participants) included in a narrative synthesis; 343 outcomes were extracted verbatim and pooled into 90 unique terms across six domains: physiological, nutrition, life impact, resource use, mortality and survival. Prevalent outcomes included adverse events (78% of studies), survival (54%), symptom control (39%) and mortality (31%). Key individual symptoms assessed were vomiting (41% of studies), nausea (34%) and pain (33%); 19% of studies assessed quality of life. CONCLUSIONS: Assessment focuses on survival, complications and overall symptom control. There is a need for definitions of treatment ‘success’ that are meaningful to patients, a more consistent approach to symptom assessment, and greater consideration of how to measure wellbeing in this population. SAGE Publications 2022-09-21 2022-10 /pmc/articles/PMC10150264/ /pubmed/36131489 http://dx.doi.org/10.1177/02692163221122352 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Original Articles
Bravington, Alison
Obita, George
Baddeley, Elin
Johnson, Miriam J
Murtagh, Fliss EM
Currow, David C
Boland, Elaine G
Nelson, Annmarie
Seddon, Kathy
Oliver, Alfred
Noble, Simon IR
Boland, Jason W
The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review
title The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review
title_full The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review
title_fullStr The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review
title_full_unstemmed The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review
title_short The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review
title_sort range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: a systematic review
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10150264/
https://www.ncbi.nlm.nih.gov/pubmed/36131489
http://dx.doi.org/10.1177/02692163221122352
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