title: The generalizability paradox within palliative care clinical trials.
abstract: We are increasingly recognizing that personalized advanced and chronic illness care requires meticulous assessment and management of supportive care needs across the entire disease trajectory. This requires drawing clinical decisions from a research evidence base that is presumably generalizable to a heterogeneous patient population, often with poor performance status, multi-morbidity, and a large symptom distress profile. As sometimes this is not the case, how do we improve evidence generation that can be consistently applied to all patients with advanced disease?
authors.affiliation: Division of Medical Oncology and Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina, USA; Center for Learning Health Care, Duke Clinical Research Institute, Durham, NC, USA.
authors.forename: Arif H
authors.initials: AH
authors.lastname: Kamal
authors.affiliation: Division of Medical Oncology, Department of Medicine, DUMC 3446, Durham, NC 27710, USA. jeffrey.peppercorn@dm.duke.edu.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Peppercorn
keywords: Palliative care; cancer; clinical trials