Dr. May Hua Receives National Cancer Institute Award to Study Effectiveness of Palliative Care

Dr. May Hua, Assistant Professor of Anesthesiology (In Epidemiology) at Columbia University Medical Center, is the recipient of a five-year, $2,793,872 grant award from the National Cancer Institute for her project, “Determinants of Palliative Care Effectiveness for Patients with Metastatic Cancer.”

Dr. May Hua

A growing body of literature raises concerns about the potential for “heterogeneity of effect,” in palliative care; that is, the effect of specialist palliative care may differ across hospitals and/or programs. These findings suggest that the current implementation of specialist palliative care, on a population level, may not be wholly effective. Dr. Hua's mixed-methods research project seeks to identify the impact of specialist palliative care on quality metrics for end-of-life care in patients with cancer, and to determine what operating conditions are necessary for palliative care teams to produce outcomes consistent with high-quality care.

Cancer research has been at the forefront of knowledge generation related to improving end-of-life and palliative care, with much of what we know about quality end-of-life care stemming from studies conducted in patients with cancer. These studies have served as the standard for all patients with serious illness, and specialist palliative care has become a widely implemented clinical intervention that is increasingly considered the standard of care, particularly for patients with advanced cancer. Dr. Hua’s research project seeks to again push the knowledge frontier forward by conducting a series of national studies to evaluate the effectiveness of real-world palliative care in cancer care.

Conceptual framework slide
Characteristic differences in palliative care program implementation.

Dr. Hua’s interest in the field of palliative care research stems from her clinical experiences as a critical care physician. For the past eight years, her work has centered on understanding the palliative care needs of patients with serious illness who require intensive care, ways to improve access to palliative care services, and developing methods to measure the effectiveness of specialist palliative care on a population level.

Her current aim is to focus on two central problems in the field of palliative care: First, while there has been growth in the availability of specialty palliative care programs, there is substantial heterogeneity between them; how this variability may affect patient outcomes is unknown. Second, the evidence base for specialty palliative care has been best developed in patients with advanced cancer; much less is known about the efficacy of palliative care for other populations of patients with serious illness. Consequently, her present research aims to better understand how differences in implementation of specialty palliative care may result in differences in patient outcomes in patients with metastatic cancer, and to further delineate the effect of specialty palliative care on outcomes for other populations of patients with serious illness.