TY - JOUR
T1 - Dealing with prognostic uncertainty
T2 - The role of prognostic models and websites for patients with advanced cancer
AU - Hui, David
AU - Maxwell, John P.
AU - Paiva, Carlos Eduardo
N1 - Publisher Copyright:
© 2019 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Purpose of reviewTo provide an updated overview of prognostic models in advanced cancer and highlight the role of prognostic calculators.Recent findingsIn the advanced cancer setting, many important healthcare decisions are driven by a patient's prognosis. However, there is much uncertainty in formulating prognosis, particularly in the era of novel cancer therapeutics. Multiple prognostic models have been validated for patients seen by palliative care and have a life expectancy of a few months or less, such as the Palliative Performance Scale, Palliative Prognostic Score, Palliative Prognostic Index, Objective Prognostic Score, and Prognosis in Palliative Care Study Predictor. However, these models are seldom used in clinical practice because of challenges related to limited accuracy when applied individually and difficulties with model selection, computation, and interpretation. Online prognostic calculators emerge as tools to facilitate knowledge translation by overcoming the above challenges. For example, www.predictsurvival.com provides the output for seven prognostic indexes simultaneously based on 11 variables.SummaryPrognostic models and prognostic websites are currently available to augment prognostication in the advanced cancer setting. Further studies are needed to examine their impact on prognostic accuracy, confidence, and clinical outcomes.
AB - Purpose of reviewTo provide an updated overview of prognostic models in advanced cancer and highlight the role of prognostic calculators.Recent findingsIn the advanced cancer setting, many important healthcare decisions are driven by a patient's prognosis. However, there is much uncertainty in formulating prognosis, particularly in the era of novel cancer therapeutics. Multiple prognostic models have been validated for patients seen by palliative care and have a life expectancy of a few months or less, such as the Palliative Performance Scale, Palliative Prognostic Score, Palliative Prognostic Index, Objective Prognostic Score, and Prognosis in Palliative Care Study Predictor. However, these models are seldom used in clinical practice because of challenges related to limited accuracy when applied individually and difficulties with model selection, computation, and interpretation. Online prognostic calculators emerge as tools to facilitate knowledge translation by overcoming the above challenges. For example, www.predictsurvival.com provides the output for seven prognostic indexes simultaneously based on 11 variables.SummaryPrognostic models and prognostic websites are currently available to augment prognostication in the advanced cancer setting. Further studies are needed to examine their impact on prognostic accuracy, confidence, and clinical outcomes.
KW - computers
KW - palliative care
KW - prognosis
KW - statistical models
KW - survival analysis
UR - http://www.scopus.com/inward/record.url?scp=85072297544&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85072297544&partnerID=8YFLogxK
U2 - 10.1097/SPC.0000000000000459
DO - 10.1097/SPC.0000000000000459
M3 - Review article
C2 - 31689273
AN - SCOPUS:85072297544
SN - 1751-4258
VL - 13
SP - 360
EP - 368
JO - Current opinion in supportive and palliative care
JF - Current opinion in supportive and palliative care
IS - 4
ER -