title: Evolution and effectiveness of palliative care.
abstract: OBJECTIVE
  : What is the evidence for the effectiveness of palliative medicine?
  
  
  METHODS
  : A search of the PubMed database for clinical trials using search terms "Palliative Care" or "Palliative Medicine" or "Hospice" or "end of life" and "effectiveness" was conducted, and 63 articles were returned. Of these, 10 were related to outcomes of interest related to components of palliative medicine such as quality of life, length of life, or healthcare utilization. None were randomized, controlled trials looking at a global measure of effectiveness of palliative medicine. Consequently, additional searches using Google and Google Scholar, and searching bibliographies of published articles and presentations, were conducted.
  
  
  RESULTS
  : There were not enough studies with which to perform a structured review. The findings from single trials of satisfactory methodological quality are summarized and presented.
  
  
  CONCLUSIONS
  : Palliative care has been proven to be more effective than standard approaches to care. The thrust of research must now turn to ways to ensure that palliative care is part of standard care.
authors.affiliation: Institute for Palliative Medicine at San Diego Hospice and the University of California, San Diego, CA 92103, USA. cvongunten@sdhospice.org
authors.forename: Charles F
authors.initials: CF
authors.lastname: von Gunten
mesh_terms: D001601:Bereavement; D002986:Clinical Trials as Topic; D017048:Health Care Costs; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000191:economics / Q000706:statistics & numerical data*; D010166:Palliative Care / Q000191:economics / Q000523:psychology* / Q000639:trends*; D009626:Terminology as Topic