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The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review

Seddon, Kathy; Bravington, Alison; Obita, George; Baddeley, Elin; Johnson, Miriam J.; Murtagh, Fliss E.M.; Currow, David C.; Boland, Elaine G.; Nelson, Annmarie; Oliver, Alfred; Noble, Simon I.R.; Boland, Jason W.

Authors

Kathy Seddon

George Obita

Elin Baddeley

David C. Currow

Elaine G. Boland

Annmarie Nelson

Alfred Oliver

Simon I.R. Noble



Abstract

Background: Malignant bowel obstruction, a complication of certain advanced cancers, causes severe symptoms which profoundly affect quality of life. Clinical management remains complex, and outcome assessment is inconsistent.

Aim: To identify outcomes evaluating palliative treatment for inoperable malignant bowel obstruction, as part of a four-phase study developing a core outcome set.

Design: The review is reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA); PROSPERO (ID: CRD42019150648). Eligible studies included at least one subgroup with obstruction below the ligament of Treitz undergoing palliative treatment for inoperable malignant bowel obstruction. Study quality was not assessed because the review does not evaluate efficacy.

Data sources: Medline, Embase, the Cochrane Database, CINAHL, PSYCinfo Caresearch, Open Grey and BASE were searched for trials and observational studies in October 2021.

Results: A total of 4769 studies were screened, 290 full texts retrieved and 80 (13,898 participants) included in a narrative synthesis; 343 outcomes were extracted verbatim and pooled into 90 unique terms across six domains: physiological, nutrition, life impact, resource use, mortality and survival. Prevalent outcomes included adverse events (78% of studies), survival (54%), symptom control (39%) and mortality (31%). Key individual symptoms assessed were vomiting (41% of studies), nausea (34%) and pain (33%); 19% of studies assessed quality of life.

Conclusions: Assessment focuses on survival, complications and overall symptom control. There is a need for definitions of treatment ‘success’ that are meaningful to patients, a more consistent approach to symptom assessment, and greater consideration of how to measure wellbeing in this population.

Citation

Seddon, K., Bravington, A., Obita, G., Baddeley, E., Johnson, M. J., Murtagh, F. E., Currow, D. C., Boland, E. G., Nelson, A., Oliver, A., Noble, S. I., & Boland, J. W. (2022). The range and suitability of outcome measures used in the assessment of palliative treatment for inoperable malignant bowel obstruction: A systematic review. Palliative medicine, 36(9), 1336-1350. https://doi.org/10.1177/02692163221122352

Journal Article Type Article
Acceptance Date Jul 20, 2022
Online Publication Date Sep 21, 2022
Publication Date 2022-10
Deposit Date Jul 25, 2022
Publicly Available Date Jan 11, 2023
Journal Palliative Medicine
Print ISSN 0269-2163
Publisher SAGE Publications
Peer Reviewed Peer Reviewed
Volume 36
Issue 9
Pages 1336-1350
DOI https://doi.org/10.1177/02692163221122352
Public URL https://hull-repository.worktribe.com/output/4040171

Files

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Copyright Statement
© The Authors, 2022. Re-use terms are restricted to non-commercial and no derivative uses.





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