Independent Validation of the Modified Prognosis Palliative Care Study Predictor Models in Three Palliative Care Settings

Abstract Context Accurate prognostic information in palliative care settings is needed for patients to make decisions and set goals and priorities. The Prognosis Palliative Care Study (PiPS) predictor models were presented in 2011, but have not yet been fully validated by other research teams. Objec...

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Veröffentlicht in:	Journal of pain and symptom management 2015-05, Vol.49 (5), p.853-860
Hauptverfasser:	Baba, Mika, MD, Maeda, Isseki, MD, PhD, Morita, Tatsuya, MD, Hisanaga, Takayuki, MD, Ishihara, Tatsuhiko, MD, Iwashita, Tomoyuki, MD, Kaneishi, Keisuke, MD, PhD, Kawagoe, Shohei, MD, Kuriyama, Toshiyuki, MD, PhD, Maeda, Takashi, MD, Mori, Ichiro, MD, Nakajima, Nobuhisa, MD, PhD, Nishi, Tomohiro, MD, Sakurai, Hiroki, MD, Shimoyama, Satofumi, MD, PhD, Shinjo, Takuya, MD, Shirayama, Hiroto, MD, Yamada, Takeshi, MD, PhD, Ono, Shigeki, MD, Ozawa, Taketoshi, MD, PhD, Yamamoto, Ryo, MD, Tsuneto, Satoru, MD, PhD
Format:	Artikel
Sprache:	eng
Schlagworte:	Aged Ambulatory Care - utilization Anesthesia & Perioperative Care Critical Illness - mortality Critical Illness - therapy Female Home Care Services - utilization Hospitalization - statistics & numerical data Humans Japan - epidemiology Male modified Outcome Assessment (Health Care) - methods Outcome Assessment (Health Care) - statistics & numerical data Pain Medicine Palliative Care - statistics & numerical data palliative setting Prevalence Prognosis Prognosis palliative care study predictor models prognostic score Reproducibility of Results Risk Assessment - methods Sensitivity and Specificity Survival Analysis Treatment Outcome validation study
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Zusammenfassung:	Abstract Context Accurate prognostic information in palliative care settings is needed for patients to make decisions and set goals and priorities. The Prognosis Palliative Care Study (PiPS) predictor models were presented in 2011, but have not yet been fully validated by other research teams. Objectives The primary aim of this study is to examine the accuracy and to validate the modified PiPS (using physician-proxy ratings of mental status instead of patient interviews) in three palliative care settings, namely palliative care units, hospital-based palliative care teams, and home-based palliative care services. Methods This multicenter prospective cohort study was conducted in 58 palliative care services including 16 palliative care units, 19 hospital-based palliative care teams, and 23 home-based palliative care services in Japan from September 2012 through April 2014. Results A total of 2426 subjects were recruited. For reasons including lack of followup and missing variables (primarily blood examination data), we obtained analyzable data from 2212 and 1257 patients for the modified PiPS-A and PiPS-B, respectively. In all palliative care settings, both the modified PiPS-A and PiPS-B identified three risk groups with different survival rates ( P < 0.001). The absolute agreement ranged from 56% to 60% in the PiPS-A model and 60% to 62% in the PiPS-B model. Conclusion The modified PiPS was successfully validated and can be useful in palliative care units, hospital-based palliative care teams, and home-based palliative care services.
ISSN:	0885-3924 1873-6513
DOI:	10.1016/j.jpainsymman.2014.10.010