supportive and palliative oncology literature: quantity, scope, design, challenges, and...

406 Vol. 43 No. 2 February 2012Schedule With Abstracts

PVS patients present unique challenges for every-one involved in caring for them.Families andclini-cians often face difficultly in discussing goals ofcare. Clinicians are often frustrated in what theyperceive to be meaningless and futile care, whilefamilies are caught in a commitment made longago. Patients, on the other hand, may be sufferingin a ‘‘dimensionless limbo.’’ Palliative medicinespecialists have an important responsibility in car-ing for these patients and their families.This session will focus on the clinical care of PVSpatients, guidance for families and support forstaff. A series of cases will be presented to illus-trate a practical approach for re-evaluating thetreatment goals for these patients. This ap-proach requires mastering the following skills:exploring the deeper meaning of decisionsmade by families, sharing the burden of decisionmaking with the family, explaining the currentstatus and likely future clinical course, while in-corporating identified spiritual concerns. Mean-ingful goals of care discussions for PVS patientsare often neglected by the medical community,making them particularly challenging. They rep-resent an opportunity for palliative medicinespecialists to spearhead needed reform in thecare of these patients.

SIG Symposia

Supportive and Palliative OncologyLiterature: Quantity, Scope, Design,Challenges, and Opportunities (508)Research SIGDavid Hui, MD MSc FRCPC, MD Anderson Can-cer Center, Houston, TX. Masanori Mori, MD,University of Vermont College of Medicine, Bur-lington, VT. Henrique Parsons, MD, MD Ander-son Cancer Center, Houston, TX.(All authors listed above for this session have dis-closed no relevant financial relationships.)

Objectives1. Review the quantity, scope and design of the

recent supportive and palliative oncologyliterature.

2. Examine the challenges unique to supportiveand palliative oncology research.

3. Discuss strategies for improving the quantityand quality of supportive and palliative on-cology literature.

The absolute number of palliative oncologystudies has increased over time. However the

proportion of palliative oncology publicationsrelated to the greater cancer literature has actu-ally decreased. The supportive and palliative on-cology literature is extremely diverse and highlycomplex. This session aims to provide a compre-hensive overview of the quantity, scope, and de-sign of the palliative care literature baseda recent systematic review, and to identify cur-rent challenges and opportunities for growth.The field of palliative care transects numeroushealth disciplines and domains, and coversa myriad of topics ranging from symptom man-agement to psychosocial care, spiritual issues,health services, communication, decision mak-ing, ethics, education and research methodolo-gies. The study population also varies widely,including patients with various oncologic diag-noses and at different stages of illness, theircaregivers and health professionals. Commonstudy designs to address research questions inthe supportive and palliative oncology literatureinclude case reports, case series, population-based studies, cross sectional surveys, cohortstudies, randomized controlled trials and quali-tative studies. Using a framework for classifyingsupportive and palliative oncology studies sys-tematically, we will discuss various study designsused to investigate different research topics,and highlight areas of deficiency requiring fur-ther research. We will also provide an evi-dence-based review of the many challengesassociated with conducting supportive and palli-ative oncology research, including limited fund-ing, few trained personnel, difficulty inrecruiting patients, high attrition rates, limitednumber of validated outcome measures, andlack of standardized definitions. Finally, wewill discuss practical strategies to advance sup-portive and palliative oncology research. Thelast 10 minutes will be available for questionsand discussions.

Palliative Care for Patients With HIV:Challenges and Controversies (509)HIV SIGChristopher Blais, MD MPH FACP FAAHPM,Ochsner Health System, New Orleans, LA. PeterSelwyn, MD MPH, Montefiore Medical Centerand Albert Einstein College of Medicine, Bronx,NY. Rodney Tucker, MD MMM FAAHPM, UABCenter for Palliative and Supportive Care, Birming-ham, AL. Nancy Hutton, MD FAAP FAAHPM,