To the Editor: In the study by Dr Bakitas and colleagues,1 the effects of a palliative care intervention were described as controlled and randomized. The authors state that previous “evidence for the effectiveness of this care was sparse and limited by methodological shortcomings,” including control group issues.
The frequency of intervention in this study was weekly for 4 weeks, then monthly thereafter until death or study completion. There were significant findings related to quality of life and mood, but not symptom intensity, days in the hospital or intensive care unit, or emergency department visits. If the control group had incorporated a similar component of unstructured contact, regarding this as a possible placebo effect, this might have provided a more informative comparison.
Kassabian S. Study Design and Palliative Care Intervention. JAMA. 2009;302(23):2551. doi:10.1001/jama.2009.1828