Journal Review in Surgical Palliative Care: RCTs in Surgical Palliative Care

2023 was an exciting year for Surgical Palliative Care research! Join Drs. Katie O’Connell, Ali Haruta, Lindsay Dickerson, and Virginia Wang from the University of Washington to discuss two seminal randomized controlled trials in the Surgical Palliative Care space.

Hosts:
· Dr. Katie O’Connell (@katmo15) is an Assistant Professor of Surgery at the University of Washington. She is a trauma surgeon, palliative care physician, Director of Surgical Palliative Care, and founder of the Advance Care Planning for Surgery clinic at Harborview Medical Center, Seattle, WA.
· Dr. Ali Haruta is a PGY7 Hospice & Palliative Care fellow at the University of Washington, formerly a UW General Surgery resident and Parkland Trauma/Critical Care fellow.
· Dr. Lindsay Dickerson (@lindsdickerson1) is a PGY5 General Surgery resident and current Surgical Oncology fellow at the University of Washington.
· Dr. Virginia Wang is a PGY2 General Surgery resident at the University of Washington.

Learning Objectives:
· Discuss the current state of the RCT literature in Palliative Care & Surgical Palliative Care
· Understand the primary outcomes of the Shinall and Aslakson trials as related to perioperative specialty palliative care intervention
· Identify limitations in existing surgical palliative care RCTs & further opportunities for study
· Identify underlying differences between medical oncology and surgical oncology patient populations

References:
1. Shinall MC, Martin SF, Karlekar M, et al. Effects of Specialist Palliative Care for Patients Undergoing Major Abdominal Surgery for Cancer: A Randomized Clinical Trial. JAMA Surg. 2023;158(7):747–755. doi:10.1001/jamasurg.2023.1396
https://pubmed.ncbi.nlm.nih.gov/37163249/

2. Aslakson RA, Rickerson E, Fahy B, et al. Effect of Perioperative Palliative Care on Health-Related Quality of Life Among Patients Undergoing Surgery for Cancer: A Randomized Clinical Trial. JAMA Netw Open. 2023;6(5):e2314660. doi:10.1001/jamanetworkopen.2023.14660
https://pubmed.ncbi.nlm.nih.gov/37256623/

3. Ingersoll LT, Alexander SC, Priest J, et al. Racial/ethnic differences in prognosis communication during initial inpatient palliative care consultations among people with advanced cancer. Patient Educ Couns. 2019;102(6):1098-1103. doi:10.1016/j.pec.2019.01.002
https://pubmed.ncbi.nlm.nih.gov/30642715/

4. Bakitas M, Lyons KD, Hegel MT, et al. Effects of a palliative care intervention on clinical outcomes in patients with advanced cancer: the Project ENABLE II randomized controlled trial. JAMA. 2009;302(7):741-749. doi:10.1001/jama.2009.1198
https://pubmed.ncbi.nlm.nih.gov/19690306/

5. Corn BW, Feldman DB, Hull JG, O'Rourke MA, Bakitas MA. Dispositional hope as a potential outcome parameter among patients with advanced malignancy: An analysis of the ENABLE database. Cancer. 2022;128(2):401-409. doi:10.1002/cncr.33907
https://pubmed.ncbi.nlm.nih.gov/34613617/

6. El-Jawahri A, LeBlanc TW, Kavanaugh A, et al. Effectiveness of Integrated Palliative and Oncology Care for Patients With Acute Myeloid Leukemia: A Randomized Clinical Trial. JAMA Oncol. 2021;7(2):238-245. doi:10.1001/jamaoncol.2020.6343
https://pubmed.ncbi.nlm.nih.gov/33331857/

7. More about the metrics from both the Shinall and Aslakson studies:

a. FACT-G – https://www.facit.org/measures/fact-g
b. FACIT-Pal – https://www.facit.org/measures/facit-pal
c. PROMIS-29 – https://heartbeat-med.com/resources/promis-29/
d. PROPr (PROMIS-Preference) score – https://www.proprscore.com/

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