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Prognosis palliative care study, palliative prognostic index, palliative prognostic score and objective prognostic score in advanced cancer: a prospective comparison
  1. Seung Hun Lee1,2,3,
  2. Jeong Gyu Lee1,2,3,
  3. Young Jin Choi4,
  4. Young Mi Seol4,
  5. Hyojeong Kim4,
  6. Yun Jin Kim1,3,
  7. Yu Hyeon Yi1,3,
  8. Young Jin Tak1,3,
  9. Gyu Lee Kim1,
  10. Young Jin Ra1,
  11. Sang Yeoup Lee3,5,6,
  12. Young Hye Cho3,5,
  13. Eun Ju Park3,5,
  14. Youngin Lee5,
  15. Jungin Choi5,
  16. Sae Rom Lee5,
  17. Ryuk Jun Kwon5 and
  18. Soo Min Son5
  1. 1Family Medicine, Pusan National University Hospital, Busan, Korea (the Republic of)
  2. 2Biomedical Research Institute, Pusan National University Hospital, Busan, Korea (the Republic of)
  3. 3Department of Family Medicine, Pusan National University School of Medicine, Busan, Korea (the Republic of)
  4. 4Division of Hemato-oncology, Department of Internal Medicine, Pusan National University School of Medicine, Busan, Korea (the Republic of)
  5. 5Department of Family Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea (the Republic of)
  6. 6Department of Medical Education, Pusan National University School of Medicine, Yangsan, Korea (the Republic of)
  1. Correspondence to Professor Jeong Gyu Lee, Department of Family Medicine, Pusan National University Hospital, 49241 Busan, Korea (the Republic of); eltidine{at}hanmail.net

Abstract

Background Predicting how long a patient with far advanced cancer has to live is a significant part of hospice and palliative care. Various prognostic models have been developed, but have not been fully compared in South Korea.

Objectives We aimed to compare the accuracy of the Prognosis in Palliative Care Study (PiPS), Palliative Prognostic Index (PPI), Palliative Prognostic Score (PaP) and Objective Prognostic Score (OPS) for patients with far advanced cancer in a palliative care unit in South Korea.

Methods This prospective study included patients with far advanced cancer who were admitted to a single palliative care unit at the National University Hospital. Variables for calculating the prognostic models were recorded by a palliative care physician. The survival rate was estimated using the Kaplan-Meier method. The sensitivity, specificity, positive predictive value and negative predictive value of each model were calculated.

Results A total of 160 patients participated. There was a significant difference in survival rates across all groups, each categorised through the five prognostic models. The overall accuracy (OA) of the prognostic models ranged between 54.5% and 77.6%. The OA of clinicians’ predictions of survival ranged between 61.9% and 81.3%.

Conclusion The PiPS, PPI, PaP and OPS were successfully validated in a palliative care unit of South Korea. There was no difference in accuracy between the prognostic models, and OA tended to be lower than in previous studies.

  • hospice care
  • clinical assessment
  • clinical decisions
  • communication
  • end of life care
  • terminal care

Data availability statement

No data are available. All data will be deleted after the study is completed according to the direction of the Research Ethics Committee of Pusan National University Hospital.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Data availability statement

No data are available. All data will be deleted after the study is completed according to the direction of the Research Ethics Committee of Pusan National University Hospital.

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Footnotes

  • Contributors We certify that no portion of this manuscript has been previously published, and we agree to transfer copyright to BMJ Supportive & Palliative Care in the event that this manuscript is accepted for publication. None of all of authors had a personal or financial conflict of interest.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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