1 Unidade Local de Saúde de Matosinhos, Matosinhos, Portugal.
2 Centro Hospitalar do Porto, Porto, Portugal.
Palliat Med. 2018 Feb;32(2):413-416. doi: 10.1177/0269216317705788. Epub 2017 May 10.
Prognosis is one of the most challenging questions with which physicians are confronted. Accuracy in the prediction of survival is necessary for clinical, ethical, and organizational reasons.
Evaluate young doctors' clinical prediction of survival and the aids they could get: expert opinion, Palliative Prognostic score, and Palliative Prognostic Index.
Prospective, observational study.
SETTING/PARTICIPANTS: Advanced cancer patients under observation of an inhospital palliative care team, from April to July 2014. A total of 38 patients were included, mostly male (65.8%), average age 68.5 years. Average survival time was 24 days. Follow-up concluded with death or after 90 days.
Young doctors' clinical prediction of survival was adequate at 10.5%, with 55.3% severe errors in an optimistic direction. Palliative care experts were more adequate (23.7%) and made less severe errors (42.1%). Palliative Prognostic score and Palliative Prognostic Index were even more adequate (47% and 55%, respectively) and made even less severe errors (0% and 11%, respectively). The best correlation with observed survival was achieved when palliative care experts used palliative prognostic score ( r = -0.629; p < 0.01).
Young doctors' clinical prediction of survival is often inadequate. Palliative Prognostic score, which includes clinical prediction of survival, calculated by palliative care experts had the best performance. Our results support the recommendation of using clinical prediction of survival together with prognostic scores.
预后是医生面临的最具挑战性的问题之一。出于临床、伦理和组织方面的原因，准确预测生存情况是必要的。
评估年轻医生对生存的临床预测以及他们可以获得的帮助：专家意见、姑息预后评分和姑息预后指数。
前瞻性、观察性研究。
地点/参与者：2014 年 4 月至 7 月期间，在住院姑息治疗团队观察下的晚期癌症患者。共纳入 38 例患者，主要为男性（65.8%），平均年龄 68.5 岁。平均生存时间为 24 天。随访以死亡或 90 天后结束。
年轻医生对生存的临床预测准确率为 10.5%，乐观方向的严重误差率为 55.3%。姑息治疗专家的预测更为准确（23.7%），且严重误差更少（42.1%）。姑息预后评分和姑息预后指数更为准确（分别为 47%和 55%），严重误差更少（分别为 0%和 11%）。姑息治疗专家使用姑息预后评分时与观察生存的相关性最佳（r=-0.629，p<0.01）。
年轻医生对生存的临床预测往往不准确。包含生存预测的姑息预后评分，由姑息治疗专家计算，表现最佳。我们的研究结果支持推荐使用临床预测与预后评分相结合。
