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Accuracy of prognosis estimates by four palliative care teams: a prospective cohort study.

Higginson IJ, Costantini M - BMC Palliat Care (2002)

Bottom Line: Prognosis estimates (minimum - maximum) at referral, patient characteristics, were recorded by staff, and later compared with actual survival.CONCLUSIONS: Offering a prognosis range has higher levels of accuracy (about double) than traditional estimates, but is still very often inaccurate, except very close to death.Where possible clinicians should discuss scenarios with patients, rather than giving a prognosis range.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dept, Palliative Care and Policy, Guy's, King's and St Thomas' School of Medicine, King's College London, Weston Education Centre, Cutcombe Road, Denmark Hill, London, SE5 9PJ, England. irene.higginson@kcl.ac.uk

ABSTRACT
BACKGROUND: Prognosis estimates are used to access services, but are often inaccurate. This study aimed to determine the accuracy of giving a prognosis range. METHODS AND MEASUREMENTS: A prospective cohort study in four multi-professional palliative care teams in England collected data on 275 consecutive cancer referrals who died. Prognosis estimates (minimum - maximum) at referral, patient characteristics, were recorded by staff, and later compared with actual survival. RESULTS: Minimum survival estimates ranged <1 to 364 days, maximum 7 - 686 days. Mean patient survival was 71 days (range 1 - 734). In 42% the estimate was accurate, in 36% it was over optimistic and in 22% over pessimistic. When the minimum estimate was less than 14 days accuracy increased to 70%. Accuracy was related, in multivariate analysis, to palliative care team and (of borderline significance) patient age. CONCLUSIONS: Offering a prognosis range has higher levels of accuracy (about double) than traditional estimates, but is still very often inaccurate, except very close to death. Where possible clinicians should discuss scenarios with patients, rather than giving a prognosis range.

No MeSH data available.


Related in: MedlinePlus

Estimated survival in days (maximum and minimum) versus actual survival.
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Related In: Results  -  Collection


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Figure 1: Estimated survival in days (maximum and minimum) versus actual survival.


Accuracy of prognosis estimates by four palliative care teams: a prospective cohort study.

Higginson IJ, Costantini M - BMC Palliat Care (2002)

Estimated survival in days (maximum and minimum) versus actual survival.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC88964&req=5

Figure 1: Estimated survival in days (maximum and minimum) versus actual survival.
Bottom Line: Prognosis estimates (minimum - maximum) at referral, patient characteristics, were recorded by staff, and later compared with actual survival.CONCLUSIONS: Offering a prognosis range has higher levels of accuracy (about double) than traditional estimates, but is still very often inaccurate, except very close to death.Where possible clinicians should discuss scenarios with patients, rather than giving a prognosis range.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dept, Palliative Care and Policy, Guy's, King's and St Thomas' School of Medicine, King's College London, Weston Education Centre, Cutcombe Road, Denmark Hill, London, SE5 9PJ, England. irene.higginson@kcl.ac.uk

ABSTRACT
BACKGROUND: Prognosis estimates are used to access services, but are often inaccurate. This study aimed to determine the accuracy of giving a prognosis range. METHODS AND MEASUREMENTS: A prospective cohort study in four multi-professional palliative care teams in England collected data on 275 consecutive cancer referrals who died. Prognosis estimates (minimum - maximum) at referral, patient characteristics, were recorded by staff, and later compared with actual survival. RESULTS: Minimum survival estimates ranged <1 to 364 days, maximum 7 - 686 days. Mean patient survival was 71 days (range 1 - 734). In 42% the estimate was accurate, in 36% it was over optimistic and in 22% over pessimistic. When the minimum estimate was less than 14 days accuracy increased to 70%. Accuracy was related, in multivariate analysis, to palliative care team and (of borderline significance) patient age. CONCLUSIONS: Offering a prognosis range has higher levels of accuracy (about double) than traditional estimates, but is still very often inaccurate, except very close to death. Where possible clinicians should discuss scenarios with patients, rather than giving a prognosis range.

No MeSH data available.


Related in: MedlinePlus