To the Editor: Dr Zimmermann and colleagues1 concluded that there is scant evidence to support the effectiveness of specialized palliative care. There are at least 3 reasons to question the study's methods and findings.
First, of the 22 selected trials, 1 did not include non–palliative care controls (reference 28 in the original article), 9 trials (references 30, 31, 33, 36, 39, 42, 43, 46, and 48 in the original article) did not involve interventions that met currently accepted definitions of palliative care services,2 and 3 were conducted more than 20 years ago (references 47, 48, and 49 in the original article). Second, a key outcome in this review was quality of life, using measures heavily influenced by physical function. Function is expected to decline in the setting of advanced illness. Function-based quality-of-life measures are not relevant in assessing palliative care's impact.3 Third, the review is limited to randomized controlled trials (RCTs) and excludes well-designed quasi-experimental/observational studies.
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 2
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
and access these and other features:
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.