Showing papers by "Michael I. Bennett published in 2000"

Using the modified Barthel index to estimate survival in cancer patients in hospice: observational study.

Abstract: Professionals in palliative care often base clinical decisions on estimated prognosis, but it has been shown that they are less accurate than the Karnofsky index at predicting prognosis in terminally ill patients. 1 2 Because our clinical experience suggested that in patients in hospice the rate of change in physical functioning was a more useful indicator of survival than absolute measures, we investigated the use of rate of change of physical function in estimating survival of terminally ill patients with cancer by using the modified Barthel index. This comprises 10 activities of daily living, each with five levels of dependency; the maximum score is 100 points, representing independence in daily living. We thought it was a more sensitive index for measuring physical functioning in this patient …

Using bisphosphonates to control the pain of bone metastases: evidence-based guidelines for palliative care.

Abstract: This work was undertaken by the Science Committee of the Association for Palliative Medicine of Great Britain and Ireland (APM) as a demonstration project in developing clinical guidelines relevant to palliative care from a pragmatic approach to literature review and grading of clinical evidence. CANCERLIT and Embase were searched for relevant papers written in English, published since 1980. Each study identified was rated against agreed criteria for levels of evidence. Most studies were not specifically designed to define speed of response, and were not undertaken in palliative care patients. Thus, careful reading and grading of each study was necessary. Sufficient evidence was identified to make recommendations for clinical practice in a palliative care population of patients, and areas for future research have been identified. Bisphosphonates appear to have a role in managing pain from metastases which has been refractory to conventional analgesic management and where oncological or orthopaedic intervention is delayed or inappropriate.