Annals of oncology : official journal of the European Society for Medical Oncology
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This study analyses the potential discriminative characteristics for patients with incurable cancer who received palliative chemotherapy during their last month of life. ⋯ The results indicate covariations between palliative chemotherapy treatments in the last month of life and unfavorable patient outcomes. As almost one of four patients with incurable cancer received their last round of palliative chemotherapy <31 days before death, there is a potential for improved routines.
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Evaluating research outcomes requires multinational cooperation in clinical research for optimization of treatment strategies and comparative effectiveness research, leading to evidence-based practice and healthcare cost containment. The European Clinical Research Infrastructures Network (ECRIN) is a distributed ESFRI (European Strategy Forum on Research Infrastructures) roadmap pan-European infrastructure designed to support multinational clinical research, making Europe a single area for clinical studies, taking advantage of its population size to access patients, and unlocking latent scientific potential. Servicing multinational trials started during its preparatory phase, and ECRIN will now apply for an ERIC (European Research Infrastructures Consortium) status by 2011. By creating a single area for clinical research in Europe, this achievement will contribute to the implementation of the Europe flagship initiative 2020 'Innovation Union', whose objectives include defragmentation of the research and education capacity, tackling the major societal challenges starting with the area of healthy ageing, and removing barriers to bring ideas to the market.
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Chapter 1 introduces the key questions and context for the work described in the supplement, on the impact of the process of clinical research on healthcare outcomes. The distinction between the influence of research activity on the outcomes for individual patients involved in clinical trials and other well-designed studies when compared to similar individuals cared for within similar healthcare institutions are considered. The evidence is reviewed and broadly the conclusion is that there is little evidence to support the hypothesis that individuals included in randomized trials do better than individuals with the same clinical characteristics in such trials within the same institution. ⋯ There are less research data which address this question and it is harder to study. However, the existing data are encouraging and suggest that the hypothesis that research- intensive healthcare institutions provide improved outcomes is worthy of further study. There is a pressing need for additional high-quality, methodologically robust studies of this question.