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KMID : 1039620150050020089
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Korean Journal of Family Practice
2015 Volume.5 No. 2 p.89 ~ p.94
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Clinical Prediction of Survival in Terminal Cancer Patients: Individual Assessment vs. Interdisciplinary Assessment
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Yoon Hyun-Soo
Kim Chul-Min
Lee Yong-Joo
Yoon Jo-Hi
Jung Ha-Ji
Sin Eun-Kyung
Chang Seung-Nam
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Abstract
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Background: Clinician’s’ survival predictions show significant correlations with actual survival, and have been demonstrated to add to the objective prognostic tools in terminal cancer. However, no studies have been conducted on the effects of team assessment for predicting survival in terminal cancer patients. Hence, the aim of this study was to verify the validity of the individual and team approaches for clinical prediction of survival in terminal cancer patients.
Me thods: This was a prospective observational study of 137 patients in a specialized hospice unit. Four doctors predicted each patient’s survival. The patients were categorized in three groups according to their predicted survival time. The correlation between the survival time and clinical expectancy was analyzed by using the Spearman correlation. Moreover, we analyzed the degree of consistency of the evaluators by using Cohen kappa and intra-class correlation analyses.
Results: The interdisciplinary team predictions were significantly correlated with the actual survival times of the patients. The clinical predictions showed some significant differences between the doctors. Furthermore, the patients with less than 10 days of survival time showed significantly higher levels of lactate dehydrogenase, C-reactive protein, and total bilirubin and a lower Palliative Performance Scale score.
Conclusion: Team assessment may serve as a good measurement to reduce the deviations associated with individual clinician’s predictions. The results of this study reemphasize the validity of interdisciplinary assessment of hospice care by analyzing the concordance of each clinician’s survival prediction.
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KEYWORD
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Cancer, Palliative Care, Survival, Team Assessment
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