2 Also, the different ways in which palliative care and end-of-life care are organized, and thus registered, across care settings and countries, pose a challenge. This means that these studies typically miss individuals who had another outcome than death.
#END OF LIFE CARE HOW TO#
An example is how to address the issue of prognostic uncertainty in retrospective cohorts of decedents: while, in practice, care providers, and patients make choices about treatments and care prospectively, with a considerable degree of uncertainty as to what will happen in the future, researchers selecting decedents and looking back at the trajectory leading to death already know the final outcome.
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However, big data research in this field also holds considerable challenges. When looking specifically at the field of palliative and end-of-life care research, big data is particularly promising as it has the potential to overcome some of the usual difficulties that come with traditional research design, such as the difficulty to recruit and retain a sufficient number of study participants. This makes it possible, for instance, to combine data about health care use, socio-demographics, chronic diseases, and health expenditures. 1 Another key characteristic of these data is that they allow for linking multiple datasets from different sources at the individual level. To differentiate big data from other types of research datasets, it can be useful to think of the four V’s by which it is typically defined: volume (sources of information of uncommonly large size), variety (heterogenous types of data), velocity (data created, updated, and processed very frequently), and veracity (data of sufficient quality and accuracy to generate actionable information). Although the promises of artificial intelligence and data-driven algorithms are sometimes too rosy, it is clear that the increasing availability of large datasets of routinely collected data provides unprecedented opportunities to generate valuable knowledge. The importance of big data is even more striking in medical research and health sciences, where the limits of what we can explore are constantly being pushed. The various services that we use in our everyday life to search for a restaurant, book an appointment with the GP, listen to music, or just find our way when driving a car share a common feature: they are all at least partly fueled by data and algorithms. No commercial use is permitted unless otherwise expressly granted.In less than a decade, big data has become a staple of technological progress. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. Implementation of palliative care should account for differences across haematological malignancies.Įnd-of-life care hematologic neoplasms intensive care palliative care. However, substantial variation according to the type of haematological malignancy suggests that the patients should not be considered as one homogeneous group. There is a need for a better and earlier integration of the palliative care approach in the standard practice of haematology. Overall, 5.5% of haematology patients died in palliative care units.Ī high proportion of patients who died from haematological malignancies receive specific treatments near the end of life. Palliative status was reported 30 days before death in only 14.8% of patients, and at time of death in 46.9% of cases. Invasive ventilation was used in 10.2% of patients with acute leukaemia but in 19.0% of patients with Hodgkin's lymphoma (P<0.001). The use of chemotherapy during the last month of life varied from 8.6% among patients with chronic myeloid leukaemia up to 30.1% among those with non-Hodgkin's lymphoma (P<0.001).
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![end of life care end of life care](https://image.slideserve.com/1263867/definitions2-l.jpg)
We found important variations between haematological malignancies. Of 46 629 inpatients who died with haematological malignancies, 24.5% received chemotherapy during the last month before death, 48.5% received blood transfusion, 12.3% were under invasive ventilation and 18.1% died in intensive care units. Percentages are adjusted for sex and age using direct standardisation. Outcomes included use of invasive cancer treatments and referral to palliative care.
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Nationwide register-based study, including all hospitalised adults ≥20 years who died from haematological malignancies in France in 2010-2013. To investigate patterns of care during the last months of life of hospitalised patients who died from different haematological malignancies.