You mention that the purpose of your project is to improve end of life hospice care. This is a really important goal. And since cancer cachexia is distressing to patients and families, it seems like a good topic to study. But which methods are most suited to this type of research ?
I guess the first question is how you would define “improvement” in end-of-life care in this situation. Is the goal of your project:
- To try to find an intervention that reduces the incidence of end-of-life cachexia?; OR
- To focus on ways to help families and patients to accept and understand it, with the goal of reducing psychological distress?
According to UptoDate, there have been a lot of different definitions of cancer cachexia syndrome over the years. Unfortunately, it doesn’t seem like there’s strong evidence to support the efficacy of any particular intervention. Before designing more studies, it seems important to ask why this is the case. Is it because we simply haven’t yet found and tested an intervention with intrinsic therapeutic efficacy? OR is it because it’s not realistic to expect experimental methods to be able to disentangle the intrinsic efficacy of any therapeutic intervention (medical or psychological) from statistical noise when “syndromes” are used as trial inclusion criteria ? The End of the “Syndrome” in Critical Care