TY - JOUR
T1 - The relative accuracy of the clinical estimation of the duration of life for patients with end of life cancer
AU - Viganò, Antonio
AU - Dorgan, Marlene
AU - Bruera, Eduardo
AU - Suarez-Almazor, Maria E.
PY - 1999/7/1
Y1 - 1999/7/1
N2 - BACKGROUND. Although the prediction of the duration of life of patients with end of life cancer most often relies on the clinical estimation of survival (CES) made by the treating physician, the accuracy and practical value of CES remains controversial. METHODS. The authors prospectively evaluated the accuracy of CES in an inception and population-based cohort of 233 cancer patients who were seen at the onset of their terminal phase. They also systematically reviewed the literature on CES in advanced or end-stage cancer patients in MEDLINE, CANCERLIT, and EMBASE data bases, using two search strategies developed by a research librarian. RESULTS. CES had low sensitivity in detecting patients who died within shorter time frames (≤2 months), and a tendency to overestimate survival was noted. A moderate correlation was observed between actual survival (AS) and CES (Pearson correlation coefficient = 0.47, intraclass correlation coefficient = 0.46, weighted kappa coefficient = 0.42). CONCLUSIONS. Treating physicians appear to overestimate the duration of life of end of life ill cancer patients, particularly those patients who die early in the terminal phase and who may potentially benefit from earlier participation in palliative care programs. CES should be considered one of many criteria, rather than a unique criterion, by which to choose therapeutic intervention or health care programs for patients in the end of life cancer phase.
AB - BACKGROUND. Although the prediction of the duration of life of patients with end of life cancer most often relies on the clinical estimation of survival (CES) made by the treating physician, the accuracy and practical value of CES remains controversial. METHODS. The authors prospectively evaluated the accuracy of CES in an inception and population-based cohort of 233 cancer patients who were seen at the onset of their terminal phase. They also systematically reviewed the literature on CES in advanced or end-stage cancer patients in MEDLINE, CANCERLIT, and EMBASE data bases, using two search strategies developed by a research librarian. RESULTS. CES had low sensitivity in detecting patients who died within shorter time frames (≤2 months), and a tendency to overestimate survival was noted. A moderate correlation was observed between actual survival (AS) and CES (Pearson correlation coefficient = 0.47, intraclass correlation coefficient = 0.46, weighted kappa coefficient = 0.42). CONCLUSIONS. Treating physicians appear to overestimate the duration of life of end of life ill cancer patients, particularly those patients who die early in the terminal phase and who may potentially benefit from earlier participation in palliative care programs. CES should be considered one of many criteria, rather than a unique criterion, by which to choose therapeutic intervention or health care programs for patients in the end of life cancer phase.
KW - End of life cancer
KW - Life expectancy
KW - Prognosis
KW - Survival
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U2 - 10.1002/(SICI)1097-0142(19990701)86:1<170::AID-CNCR23>3.0.CO;2-S
DO - 10.1002/(SICI)1097-0142(19990701)86:1<170::AID-CNCR23>3.0.CO;2-S
M3 - Article
C2 - 10391577
AN - SCOPUS:0033168454
SN - 0008-543X
VL - 86
SP - 170
EP - 176
JO - Cancer
JF - Cancer
IS - 1
ER -