Survival prediction for advanced cancer patients in the real world:
A comparison of the Palliative Prognostic Score, Delirium-Palliative Prognostic Score, Palliative Prognostic Index and modified Prognosis in Palliative CareStudy predictor model.
Baba M1,
Maeda I2,
Morita T3,
Inoue S4,
Ikenaga M5,
Matsumoto Y6,
Sekine R7,
Yamaguchi T8,
Hirohashi T9,
Tajima T10,
Tatara R11,
Watanabe H12,
Otani H13,
Takigawa C14,
Matsuda Y15,
Nagaoka H16,
Mori M17,
Tei Y18,
Hiramoto S19,
Suga A20,
Kinoshita H21.
Abstract
PURPOSE:
The aim of this study was to investigate the feasibility and accuracy of the Palliative Prognostic Score (PaP score), Delirium-PalliativePrognostic Score (D-PaP score), Palliative Prognostic Index (PPI) and modified Prognosis in Palliative Care Study predictor model (PiPS model).
PATIENTS AND METHODS:
This multicentre prospective cohort study involved 58 palliative care services, including 19 hospital palliative careteams, 16 palliative care units and 23 home palliative care services, in Japan from September 2012 to April 2014. Analyses were performed involving four patient groups: those treated by palliative care teams, those in palliative care units, those at home and those receiving chemotherapy.
RESULTS:
We recruited 2426 participants, and 2361 patients were finally analysed. Risk groups based on these instruments successfully identified patients with different survival profiles in all groups. The feasibility of PPI and modified PiPS-A was more than 90% in all groups, followed by PaP and D-PaP scores; modified PiPS-B had the lowest feasibility. The accuracy of prognostic scores was ⩾69% in all groups and the difference was within 13%, while c-statistics were significantly lower with the PPI than PaP and D-PaP scores.
CONCLUSION:
The PaP score, D-PaP score, PPI and modified PiPS model provided distinct survival groups for patients in the three palliative caresettings and those receiving chemotherapy. The PPI seems to be suitable for routine clinical use for situations where rough estimates of prognosis are sufficient and/or patients do not want invasive procedure. If clinicians can address more items, the modified PiPS-A would be a non-invasive alternative. In cases where blood samples are available or those requiring more accurate prediction, the PaP and D-PaP scores and modified PiPS-B would be more appropriate.
Copyright © 2015 Elsevier Ltd. All rights reserved.
KEYWORDS:
Accuracy; Palliative Prognostic Index; Palliative Prognostic Score; Palliative care; PiPS model; Predication; Prognosis
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