Evidence map›Paper›PMID 39447848›Full record

ArticleJournal of pain and symptom management2025

Variation in Palliative Care Program Performance for Patients With Metastatic Cancer.

May Hua, Ling Guo, Caleb Ing, Shuang Wang, R Sean Morrison

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of pain and symptom management, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

May HuaDepartment of Anesthesiology (M.H., C.I.), College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY. Electronic address: mh2633@cumc.columbia.edu.
Ling GuoDepartment of Anesthesiology (L.G.), College of Physicians and Surgeons, Columbia University, New York, NY.
Caleb IngDepartment of Anesthesiology (M.H., C.I.), College of Physicians and Surgeons, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY.
Shuang WangDepartment of Biostatistics (S.W.), Mailman School of Public Health, Columbia University, New York, NY.
R Sean MorrisonIcahn School of Medicine at Mount Sinai and James J Peters VA (R.S.M.), Bronx New York, USA.

Funding

Residing in the Community with Dementia at the End of Life: Understanding Hospice Use and Residential SettingP30AG028741 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI ALBERT L SIU · 2010 to 2026
$21.9M
Advanced-Stage Development of a Geriatric Palliative Care Research InfrastructureR33AG065726 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI ALDRIDGE, MELISSA DIANE, MORRISON, R. SEAN · 2020 to 2024
$3.4M
Determinants of Palliative Care Effectiveness for Patients with Metastatic CancerR37CA246565 · NCI · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI May Hua · 2021 to 2026
$3.3M
NCI NIH HHS R37 CA246565NIA NIH HHS P30 AG028741NIA NIH HHS R33 AG065726
6 · The paper itself

Abstract

contextWhile specialist palliative care is associated with improved end-of-life quality metrics for patients with advanced cancer, its effectiveness may differ between hospitals.

objectivesTo examine variation in palliative care program performance on end-of-life care quality metrics.

methodsRetrospective cohort study of palliative care programs that participated in the National Palliative Care Registry, 2018-2019. Medicare data for patients age ≥65 who died with metastatic cancer were aggregated on a program-level. Variation in program performance on outcomes (use of hospice, hospice enrollment ≥3 days, use of intensive care in the last 30 days of life, and use of chemotherapy in the last 14 days of life) was quantified by risk-standardized outcome rates (RSOR) and adjusted median odds ratios (aMOR).

resultsThe cohort comprised 235 palliative care programs who delivered care to 33,015 patients. There was substantial variation in use of hospice (median RSOR 65.6%, interquartile range (IQR) 57.5%-74.3%), hospice enrollment ≥3 days (median RSOR 53.6%, IQR 48.6%-58.2%), and use of intensive care (median RSOR 14.1%, IQR 13.1%-15.3%), but not use of chemotherapy (median RSOR 1.5%, IQR 1.4%-1.5%). Variation was greatest for hospice use (aMOR 1.48 [1.39-1.57]), suggesting that patients at programs with high hospice use would be 48% more likely to use hospice than if they received care at programs with low use.

conclusionWe found variation in most end-of-life quality metrics for patients with metastatic cancer. Further work is needed to better understand why variations exist and whether such variations reflect a difference in quality of care.

Indexed as

Hospice CareMedicareNeoplasmsPalliative CareAgedAged, 80 and overFemaleHumansMaleNeoplasm MetastasisQuality of Health CareRegistriesRetrospective StudiesTerminal CareUnited StatesHospiceIntensive care unitNeoplasmPalliative careQuality of life

Identifiers

PMID39447848
PMCPMC11659036

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.