Clinicians’ Prediction of Survival Is Most Useful for Palliative Care Referral
Background: Timely palliative transition in patients with advanced cancer is essential for their improved quality of life and overall survival (OS). Most prognostic models have been developed focusing on weeks’ survival. The current study aimed to compare the accuracies of several indicators, such a...
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| Format: | Article |
| Language: | English |
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Mary Ann Liebert
2024-10-01
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| Series: | Palliative Medicine Reports |
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| Online Access: | https://www.liebertpub.com/doi/10.1089/pmr.2024.0013 |
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| author | Eun Hee Jung Yusuke Hiratsuka Sang-Yeon Suh Seok-Joon Yoon Beodeul Kang Si Won Lee Koung Jin Suh Ji-Won Kim Se Hyun Kim Jin Won Kim Keun-Wook Lee Yu Jung Kim |
| author_facet | Eun Hee Jung Yusuke Hiratsuka Sang-Yeon Suh Seok-Joon Yoon Beodeul Kang Si Won Lee Koung Jin Suh Ji-Won Kim Se Hyun Kim Jin Won Kim Keun-Wook Lee Yu Jung Kim |
| author_sort | Eun Hee Jung |
| collection | DOAJ |
| description | Background: Timely palliative transition in patients with advanced cancer is essential for their improved quality of life and overall survival (OS). Most prognostic models have been developed focusing on weeks’ survival. The current study aimed to compare the accuracies of several indicators, such as the Karnofsky Performance Scale (KPS), Clinicians’ Prediction of Survival (CPS), and Edmonton Symptom Assessment System (ESAS), for predicting the survival of patients. Methods: Two hundred patients were enrolled at a single tertiary cancer center in South Korea between 2016 and 2019. We compared the discrimination of CPS versus KPS and ESAS total scores using the area under the receiver operating characteristic curve (AUROC) in 3-month and 6-month survival predictions. Results: The median age of patients was 66.0 years, and 128 (64%) were male. Two-thirds (66%) of the patients had an Eastern Cooperative Oncology Group performance status of 0 or 1, and 55.5% had a KPS of 80% or higher. The values of AUROC of CPS, KPS, and ESAS total score in 3-month survival prediction were 0.80 (95% confidence interval [CI]: 0.73–0.88), 0.71 (95% CI: 0.62–0.79), and 0.71 (95% CI: 0.62–0.81), respectively, whereas those in 6-month survival were 0.82 (95% CI: 0.76–0.88), 0.70 (95% CI: 0.63–0.78), and 0.63 (95% CI: 0.55–0.71), respectively. Conclusion: CPS showed the highest accuracy in predicting 3- and 6-month survival, whereas KPS had an acceptable accuracy. Experienced clinicians can rely on CPS to predict survival in months. We recommend the use of KPS with CPS to assist inexperienced clinicians. |
| format | Article |
| id | doaj-art-2b11949bf4df41c2bc5f6f5603ccfa7d |
| institution | Kabale University |
| issn | 2689-2820 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | Mary Ann Liebert |
| record_format | Article |
| series | Palliative Medicine Reports |
| spelling | doaj-art-2b11949bf4df41c2bc5f6f5603ccfa7d2025-08-20T03:49:37ZengMary Ann LiebertPalliative Medicine Reports2689-28202024-10-015136537210.1089/pmr.2024.0013Clinicians’ Prediction of Survival Is Most Useful for Palliative Care ReferralEun Hee Jung0Yusuke Hiratsuka1Sang-Yeon Suh2Seok-Joon Yoon3Beodeul Kang4Si Won Lee5Koung Jin Suh6Ji-Won Kim7Se Hyun Kim8Jin Won Kim9Keun-Wook Lee10Yu Jung Kim11Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.Department of Palliative Medicine, Takeda General Hospital, Aizu Wakamatsu, Japan.Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang-si, South Korea.Department of Family Medicine, Chungnam National University Hospital, Daejeon, South Korea.Division of Medical Oncology, Bundang Medical Center, CHA University, Seongnam-si, South Korea.Palliative Care Center, Yonsei Cancer Center, Yonsei University Health System, Seoul, South Korea.Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.Division of Hematology and Medical Oncology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.Background: Timely palliative transition in patients with advanced cancer is essential for their improved quality of life and overall survival (OS). Most prognostic models have been developed focusing on weeks’ survival. The current study aimed to compare the accuracies of several indicators, such as the Karnofsky Performance Scale (KPS), Clinicians’ Prediction of Survival (CPS), and Edmonton Symptom Assessment System (ESAS), for predicting the survival of patients. Methods: Two hundred patients were enrolled at a single tertiary cancer center in South Korea between 2016 and 2019. We compared the discrimination of CPS versus KPS and ESAS total scores using the area under the receiver operating characteristic curve (AUROC) in 3-month and 6-month survival predictions. Results: The median age of patients was 66.0 years, and 128 (64%) were male. Two-thirds (66%) of the patients had an Eastern Cooperative Oncology Group performance status of 0 or 1, and 55.5% had a KPS of 80% or higher. The values of AUROC of CPS, KPS, and ESAS total score in 3-month survival prediction were 0.80 (95% confidence interval [CI]: 0.73–0.88), 0.71 (95% CI: 0.62–0.79), and 0.71 (95% CI: 0.62–0.81), respectively, whereas those in 6-month survival were 0.82 (95% CI: 0.76–0.88), 0.70 (95% CI: 0.63–0.78), and 0.63 (95% CI: 0.55–0.71), respectively. Conclusion: CPS showed the highest accuracy in predicting 3- and 6-month survival, whereas KPS had an acceptable accuracy. Experienced clinicians can rely on CPS to predict survival in months. We recommend the use of KPS with CPS to assist inexperienced clinicians.https://www.liebertpub.com/doi/10.1089/pmr.2024.0013advanced cancerpalliative carepredictionsurvival |
| spellingShingle | Eun Hee Jung Yusuke Hiratsuka Sang-Yeon Suh Seok-Joon Yoon Beodeul Kang Si Won Lee Koung Jin Suh Ji-Won Kim Se Hyun Kim Jin Won Kim Keun-Wook Lee Yu Jung Kim Clinicians’ Prediction of Survival Is Most Useful for Palliative Care Referral Palliative Medicine Reports advanced cancer palliative care prediction survival |
| title | Clinicians’ Prediction of Survival Is Most Useful for Palliative Care Referral |
| title_full | Clinicians’ Prediction of Survival Is Most Useful for Palliative Care Referral |
| title_fullStr | Clinicians’ Prediction of Survival Is Most Useful for Palliative Care Referral |
| title_full_unstemmed | Clinicians’ Prediction of Survival Is Most Useful for Palliative Care Referral |
| title_short | Clinicians’ Prediction of Survival Is Most Useful for Palliative Care Referral |
| title_sort | clinicians prediction of survival is most useful for palliative care referral |
| topic | advanced cancer palliative care prediction survival |
| url | https://www.liebertpub.com/doi/10.1089/pmr.2024.0013 |
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