Evidence map›Paper›PMID 39506822›Full record

ArticleTrials2024

Implementing palliative care in hepatocellular carcinoma ambulatory clinics-study protocol for Accelerated translational research in PRImary liver CAncer (APRICA) randomised controlled palliative care trial.

Cameron Gofton, Anna Di Bartolomeo, Rose Boutros, Yvonne A Zurynski, Fiona Stafford-Bell, Kim Caldwell, Geoffrey McCaughan, Amany Zekry, Simone I Strasser, Miriam Levy and 11 more

Abstract readClinical Trial Protocol
In one paragraph

Article in Trials, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–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

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
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

21 authors.

Cameron GoftonStorr Liver Centre, Westmead Hospital, WSLHD, Westmead Institute for Medical Researchand, University of Sydney, Westmead, Australia. Cameron.Gofton@health.nsw.gov.au.ORCID http://orcid.org/0000-0002-0913-7180
Anna Di BartolomeoStorr Liver Centre, Westmead Hospital, WSLHD, Westmead Institute for Medical Researchand, University of Sydney, Westmead, Australia.
Rose BoutrosStorr Liver Centre, Westmead Hospital, WSLHD, Westmead Institute for Medical Researchand, University of Sydney, Westmead, Australia.
Yvonne A ZurynskiAustralian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Fiona Stafford-BellDepartment of Palliative Care, Liverpool Hospital, SWSLHD, Liverpool, Australia.
Kim CaldwellDepartment of Palliative Care, St George Hospital, SESLHD, Kogarah, Sydney, Australia.
Geoffrey McCaughanA W Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, SLHD and University of Sydney, Camperdown, Australia.
Amany ZekryDepartment of Gastroenterology and Hepatology, St George Hospital, SESLHD, Kogarah, Sydney, Australia.
Simone I StrasserA W Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, SLHD and University of Sydney, Camperdown, Australia.
Miriam LevyDepartment of Gastroenterology and Hepatology, Liverpool Hospital, SWSLHD, Liverpool, Australia.
Caitlin SheehanResearch Southern Sector, Department of Palliative Care, St George Hospital, SESLHD, Kogarah, Sydney, Australia.
Stephen GoodallUniversity of Technology Sydney, Ultimo, Australia.
Jan Maree DavisPalliative Care Service, SESLHD Southern Sector, Kogarah, Australia.
Linda SheahanDepartment of Palliative Care, St George Hospital, SESLHD, Kogarah, Sydney, Australia.
Ken LiuA W Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, SLHD, Camperdown, Sydney, Australia.
Sally GreenawayDepartment of Palliative Care, Westmead Hospital, Westmead, Australia.
Scott DavisonDepartment of Gastroenterology and Hepatology, Liverpool Hospital, SWSLHD, Liverpool, Australia.
Thang Du HuynhDepartment of Palliative Care, Liverpool Hospital, SWSLHD, Liverpool, Australia.
Zujaj QuadriDepartment of Palliative Care, Liverpool Hospital, SWSLHD, Liverpool, Australia.
Meera AgarUniversity of Technology Sydney, Ultimo, Australia.
Jacob GeorgeStorr Liver Centre, Westmead Hospital, WSLHD, Westmead Institute for Medical Researchand, University of Sydney, Westmead, Australia. Jacob.George@sydney.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIntegration of symptom and palliative care for people with advanced cancer is established in many tumour types, but its role in people with hepatocellular carcinoma (HCC) has not been clearly defined. This study aims to evaluate the clinical and cost effectiveness of an intervention involving a suite of strategies designed to assess and treat palliative care symptoms and needs in adult outpatients with HCC attending four New South Wales (NSW) metropolitan tertiary hospitals.

methodsThis trial will use a pragmatic cluster-based randomised-controlled design, with ambulatory HCC services as the clusters. HCC patients will be recruited if they have Barcelona Clinical Liver Cancer (BCLC) stage A disease with active tumour or a current or prior diagnosis of BCLC stage B or C disease regardless of tumour activity. Patients with BCLC stage D disease will be excluded as palliative care is the standard of care (SOC) in this group. Cluster sites will be randomised to the study intervention or control where patients are managed according to SOC. All participants will complete the liver-specific Edmonton Symptom Assessment Scale (ESAS) and European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire at regular ambulatory clinic appointments. At intervention sites, patients scoring ≥ 5 on any liver-specific ESAS symptom will be referred to palliative care physicians for consultation. The primary clinical outcome will be improvement in all symptoms scored ≥ 5 on the liver-specific ESAS by 50% within 3 months and the primary implementation outcome will recording the liver-specific ESAS in ≥ 80% of all participants attending clinic appointments. Caregivers of patients enrolled in the trial will be invited to perform Carer Support Needs Assessment Tool at each appointment. DISCUSSION: This trial will inform if earlier palliative care involvement significantly reduces the symptom burden associated with HCC. If found to be effective, earlier implementation of palliative care consultation should be included in HCC treatment guidelines.

trial registrationACTRN12623000010695. Registered on September 1, 2023.

Indexed as

Carcinoma, HepatocellularLiver NeoplasmsPalliative CareQuality of LifeAmbulatory Care FacilitiesCost-Benefit AnalysisHumansMulticenter Studies as TopicNew South WalesPragmatic Clinical Trials as TopicTranslational Research, BiomedicalTreatment Outcome

Identifiers

PMID39506822
PMCPMC11542352

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

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.