Palliative care research: State of play and journal direction

What is the state of play in palliative care research? Do we reflect that as a journal? We want to reflect, where possible, the cutting edge of research in the field, promote the highest possible standards of palliative care research, encourage wide research dissemination and work to facilitate the translation of research evidence into impact on all aspects of palliative care practice and policy. It is hard, however, to determine what the current situation is with palliative care research internationally. While there are an increasing number of atlases of palliative care, international, regional and national, few explicitly map palliative care research resource, although its importance is often acknowledged. The latest EAPC Atlas of Palliative Care in Europe1 does outline research capacity in each country, but this tells us little about the type, quality and quantity of research undertaken. In the United Kingdom, the academic palliative care research groups have been called ‘fragile’, with little growth noted during the 2000s.2 Studies of palliative care research tell us a little more about focus, quality and type of research. National studies, such as those in Sweden and Ireland, identify upward trends in publication numbers, and an increase in quantitative research approaches and studies outside cancer, although there remain critiques of the small scale of studies.3,4 International studies are also increasing in number, although they are predominantly observational rather than interventional.5 Trials in palliative care remain small, with low quality of reporting.6 Given these trends, we wanted to see how the research we publish in Palliative Medicine compares. Certainly, we can see an increase in the number of papers submitted to the journal over time; between 2010 and 2015, we saw a 48% increase in the number of annual submissions. More interesting perhaps is to examine the type of research we publish. While we haven’t compared with submitted research, in the first 8 editions of 2016, the papers we published comprise 29% reviews, 46% quantitative research, 19% qualitative research and 5% mixed methods. Overall, only 2.5% of the papers we published reported trials, most of the quantitative papers were cross-sectional or cohort studies. We also examined the funding declarations of these papers: 38% declared no funding source for their research, of which 62% were reporting empirical research not just reviews for which funding sources can be challenging. Studies with no funding declarations came from across continents: 17 from Europe, 3 Asian, 1 African, 5 Australian, 1 US and 4 from international groups. Of funded studies, 5% of studies we published report international funding (primarily from EU sources), 38% have national sources of funding, 10% charity, 4% academic funding and only 2% commercial funding. While this is only a small snapshot, these data mirror wider trends of increasing numbers of papers and a predominance of observational rather than interventional research. Perhaps, this isn’t surprising when the large number of studies which appear to be unfunded is taken into consideration, given the resource requirements typically associated with sufficiently powered robust trials. Observational research is critically important to answer particular types of questions, but it remains concerning that our field does not seem to be able to fully embrace common approaches to testing efficacy and outcomes of care. What is the way forwards? Clearly, for palliative care, more widely, we need to continue to focus on producing the highest possible quality of research addressing questions of importance to the field. This continues to require investment in appropriate research training and clear research career paths and posts so that competitive, high-quality grant applications result in meaningful well-reported research. We must, as a speciality, ensure that high-quality research remains central to what we do, and this must mean an increased focus on sourcing research funding. What can we do as a journal? We plan to continue our focus on maximising reporting quality and clarity so that the papers we do publish are the best they can be. This will include more emphasis on reporting guidelines and on clear presentation of abstracts, discussion sections and key statements so that readers can quickly and easily identify the main messages from the papers we do publish. Our ongoing challenge remains sourcing high-quality reviews in a timely manner, despite active management of the process. We know this is a major issue for authors and is the main source of delay in our publishing processes. Please do consider joining our reviewer team, we won’t bombard you with requests. As well as our successful annual special issues, we are also introducing ‘virtual issues’, where editors curate existing content on a particular area to enhance discoverability for readers. If you have a suggestion for a virtual issue, 680139 PMJ0010.1177/0269216316680139Palliative MedicineEditorial editorial2016