Bandolier is sometimes seen as dreadfully stuck in its ways of quantification and arithmetic, but we do recognise good studies and research projects in which the only numbers are page numbers. The giving or sustaining of hope, or its destruction, are the types of subtle intervention which take place in almost every clinical interaction but which are very rarely discussed or studied. Ontology and epistemology Ontology is the study of being or existing, a metaphysical study. Epistemology is a bit more hard-nosed, being concerned with the study of how we know things, and of course, much of philosophy from Plato to A. J. Ayer is concerned with how we know.
Research is itself part of the process of epistemology.
It would be very nice to have found 15 good quality randomised trials in which some patients had been given hope and others had not, although the complexities of designing such a single blind trial make it extremely daunting. Their conclusion, not surprisingly, was that the term was too vague and diffuse for meta-analysis of any of the results of the studies to be possible, but it is a very good example of an attempt to tackle a complex, diffuse and difficult topic. Without a clear definition of the intervention, evaluation of its effect by quantifiable means is impossible. Effectiveness of giving patients hope Unfortunately the paper comes to no conclusions, and does no analysis of any of the outcomes, not even a simple vote counting of whether the studies showed a link between outcome and hope. But the authors have identified the studies, and this would be a good place to start for anyone interested in studies on the effects of hope on patient outcome.