Background: Using the 'surprise' question 'Would you be surprised if this patient died in the next year?' may improve physicians' prognostic accuracy and identify people appropriate for palliative care.
Aim: Determine the prognostic accuracy of general practitioners asking the 'surprise' question about their patients with advanced (stage IV) cancer.
Design: Prospective cohort study.
Setting/participants: Between December 2011 and February 2012, 42 of 50 randomly selected general practitioners (Bologna area, Italy) prospectively classified 231 patients diagnosed with advanced cancer according to the 'surprise' question and supplied the status of each patient 1 year later.
Results: Of the 231 patients, general practitioners responded 'No' to the 'surprise' question for 126 (54.5%) and 'Yes' for 105 (45.5%). After 12 months, 104 (45.0%) patients had died; 87 (83.7%) were in the 'No' group. The sensitivity of the 'surprise' question was 69.3%; the specificity was 83.6%. Positive predictive value was 83.8%; negative predictive value was 69.0%. The answer to the 'surprise' question was significantly correlated with survival at 1 year. Patients in the 'No' group had an odds ratio of 11.55 (95% confidence interval: 5.83-23.28) and a hazard ratio of 6.99 (95% confidence interval: 3.75-13.03) of being dead in the next year compared to patients in the 'Yes' group (p = 0.000 for both odds ratio and hazard ratio).
Conclusion: When general practitioners used the 'surprise' question for their patients with advanced cancer, the accuracy of survival prognosis was very high. This has clinical potential as a method to identify patients who might benefit from palliative care.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1177/0269216314526273 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Consequences of Historical Exam Access versus Timely Exam feedback on knowledge Retention (CHEATER).
Am J Pharm Educ
January 2025
UNC Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC 27599. Electronic address:
Objective: To compare the impact of examination feedback versus access to historical examination questions on information retention.
Methods: First-year student-pharmacists completed a baseline knowledge assessment composed of 30 examination questions divided into three conditions of 10 questions each. In the CHEAT condition, students were provided with 10 questions and their correct answers ahead of time.
Bayesian surprise intensifies pain in a novel visual-noxious association.
Cognition
January 2025
Institute of Systems and Information Engineering, University of Tsukuba, Ibaraki 305-8573, Japan. Electronic address:
Pain perception is not solely determined by noxious stimuli, but also varies due to other factors, such as beliefs about pain and its uncertainty. A widely accepted theory posits that the brain integrates prediction of pain with noxious stimuli, to estimate pain intensity. This theory assumes that the estimated pain value is adjusted to minimize surprise, mathematically defined as errors between predictions and outcomes.
View Article and Find Full Text PDFDid Finerenone Improve Health Status in the FINEARTS Trial?: A Critical Reevaluation of the Analysis of Patient-Reported Outcomes in Heart Failure.
J Am Coll Cardiol
January 2025
Baylor Heart and Vascular Institute, Dallas, Texas, USA; Imperial College, London, United Kingdom.
Patient-reported health status is an important assessment of patients with heart failure, but current approaches have substantial methodological and analytical limitations. Changes in the Kansas City Cardiomyopathy Questionnaire (KCCQ) are commonly presented as a measure of the effect of drugs and devices, most often as the between-group difference in population means or as the odds of showing threshold changes of 5, 10, 15, and 20 points. However, the presentation of mean differences is based on statistical assumptions that are routinely violated in most trials.
View Article and Find Full Text PDF"Assessing the Effect of a Mobile Application on Cancer Risk Health Literacy: A Cross-Sectional Study Design".
Appl Clin Inform
January 2025
Radiotherapy, CHU de Liège, Liège, Belgium.
Background: The "Cancer Risk Calculator" mobile application aims to inform patients about their personal risks of cancer and their risk factors influencingsaid risks. The present analysis examines the responses to a questionnaire submitted by oncology patients treated with radiotherapy or their family members.
Objective: The primary objective was to determine the effectof the app on the user's awareness and potential habit changes related to cancer risk.
Recruitment, follow-up and survival in an 11-country cohort study of patients at the end of life and their relatives.
PLoS One
January 2025
Institute for Palliative Care, Region Skåne and Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
Background: Large, international cohort studies generate high-level evidence, but are resource intense. In end-of-life care such studies are scarce. Hence, planning for future studies in terms of data on screening, recruitment, retention and survival remains a challenge.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!