User's Guide to Research in Palliative Care: Why Is a New Series Needed?

Abstract

This paper serves as an introduction to an upcoming series in the Journal of Palliative Medicine on research methods in palliative care. The goal of the series is to enable the Journal of Palliative Medicine readership to become more critical readers of the increasingly complex methods used in palliative care research. Our aim is not to provide a “how to” for the use of various research methods (as such an undertaking requires far more than a six-article journal series), but rather to provide information to promote critical evaluation of the research methods currently used to shape and advance our practice. The development of the evidence base for palliative care now encompasses far more than quantitative experimental research methods. Not only are quasi-experimental and observational research methods increasingly utilized, qualitative research methods are providing valuable insights into palliative care. For example, the 2008 annual conference of the American Academy of Hospice and Palliative Medicine had more than 150 attendees in the research methods seminars on topics such as observational research and qualitative data analyses and such seminars were ranked among the highest by attendees. As the evidence base for palliative care builds, it is imperative that there be a broad-based understanding of the research methods used to develop this evidence base. We have chosen to focus on research methods outside of experimental methods and the randomized controlled trial (RCT) because alternative methods have become increasingly necessary to study the complex aspects of palliative care delivery. Accordingly, this series will cover the following topics: an introduction to observational and quasi-experimental research methods, the challenges of observational and quasi-experimental research including selection bias and confounding, the rationale for and meaning of analytic techniques such as instrumental variable analysis and hierarchical modeling, meta-analysis, and qualitative research methods.