title: Prospective integration of cultural consideration in biomedical research for patients with advanced cancer: recommendations from an international conference on malignant bowel obstruction in palliative care.
abstract: In the setting of an international conference on malignant bowel obstruction as a model for randomized controlled trials (RCTs) in palliative care, we discuss the importance of incorporating prospective cultural considerations into research design. The approach commonly used in biomedical research has traditionally valued the RCT as the ultimate "way of knowing" about how to best treat a medical condition. The foremost limitation of this approach is the lack of recognition of the impact of cultural viewpoints on research outcomes. We propose that interest relevant to cultural viewpoints should be emphasized in conceptualizing and interpreting research questions, designs, and results. In addition to recognizing our cultural biases as individuals and researchers, we recommend two major shifts in designing and implementing RCTs: 1) inclusion of a multidisciplinary team of researchers to inform the diversity of perspectives and expertise brought to the research, and 2) use of mixed methods of inquiry, reflecting both deductive and inductive modes of inference.
authors.affiliation: International Observatory on End of Life Care, Institute of Health Research, Lancaster University, Lancaster, United Kingdom.
authors.forename: Iris Cohen
authors.initials: IC
authors.lastname: Fineberg
authors.forename: Marcia
authors.initials: M
authors.lastname: Grant
authors.forename: Noreen M
authors.initials: NM
authors.lastname: Aziz
authors.forename: Richard
authors.initials: R
authors.lastname: Payne
authors.forename: Marjorie
authors.initials: M
authors.lastname: Kagawa-Singer
authors.forename: Geoffrey P
authors.initials: GP
authors.lastname: Dunn
authors.forename: Barry M
authors.initials: BM
authors.lastname: Kinzbrunner
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Palos
authors.forename: Susan Matsuko
authors.initials: SM
authors.lastname: Shinagawa
authors.forename: Robert S
authors.initials: RS
authors.lastname: Krouse
mesh_terms: D035843:Biomedical Research; D003469:Culture; D006801:Humans; D007414:Intestinal Neoplasms / Q000150:complications / Q000208:ethnology*; D007415:Intestinal Obstruction / Q000208:ethnology* / Q000209:etiology; D010166:Palliative Care / Q000379:methods* / Q000523:psychology