The NHMRC Clinical Trials Centre, The University of Sydney, Locked Bag 77, Camperdown, Sydney, NSW, 1450, Australia.
Sydney Medical School, The University of Sydney, Sydney, Australia.
Support Care Cancer. 2022 Sep;30(9):7763-7772. doi: 10.1007/s00520-022-07167-3. Epub 2022 Jun 15.
To evaluate a web-based tool for estimating and explaining three scenarios for expected survival time to people with advanced cancer (patients), their family members (FMs), and other healthcare professionals (HCPs).
Thirty-three oncologists estimated the "median survival of a group of similar patients" for patients seeking quantitative prognostic information. The web-based tool generated worst-case, most likely, and best-case scenarios for survival based on the oncologist's estimate. Oncologists presented the scenarios to each patient and provided a printed summary to patients, FMs, and HCPs. Attitudes to the information were assessed by questionnaires. Observed survival for each patient was compared with the oncologist's estimated survival and the three scenarios.
Prognosis was discussed with 222 patients: median age 67 years; 61% male; most common primary sites pancreas 15%, non-small-cell lung 15%, and colorectal 12%. The median (range) for observed survival times was 9 months (0.5-43) and for oncologist's estimated survival times was 12 months (2-96). Ninety-one percent of patients, 91% of FMs, and 84% of HCPs agreed that it was helpful having life expectancy explained as three scenarios. The majority (77%) of patients judged the information presented about their life expectancy to be the same or better than they had expected before the consultation. The survival estimates met a priori criteria for calibration, precision, and accuracy.
Patients, FMs, and HCPs found it helpful to receive personalized prognostic information formatted as three scenarios for survival. It was feasible, acceptable, and safe to use a web-based resource to do this.
评估一种用于向晚期癌症患者（患者）、其家属（家属）和其他医疗保健专业人员（HCP）估计和解释三种预期生存时间情景的网络工具。
33 名肿瘤学家为寻求定量预后信息的患者估计了“一组相似患者的中位生存时间”。该网络工具根据肿瘤学家的估计为生存生成了最坏情况、最可能情况和最佳情况情景。肿瘤学家向每位患者介绍了这些情景，并向患者、家属和 HCP 提供了一份打印的摘要。通过问卷调查评估了对信息的态度。观察到的每个患者的生存时间与肿瘤学家估计的生存时间和三个情景进行了比较。
与 222 名患者讨论了预后：中位年龄 67 岁；61%为男性；最常见的原发部位为胰腺 15%、非小细胞肺癌 15%和结直肠癌 12%。观察到的生存时间中位数（范围）为 9 个月（0.5-43），肿瘤学家估计的生存时间中位数为 12 个月（2-96）。91%的患者、91%的家属和 84%的 HCP 认为将预期寿命解释为三种情景很有帮助。大多数（77%）患者认为，与咨询前相比，他们对自己预期寿命的信息评估相同或更好。生存估计符合事先设定的校准、精度和准确性标准。
患者、家属和 HCP 认为以三种生存情景的形式获得个性化预后信息很有帮助。使用基于网络的资源来实现这一目标是可行、可接受且安全的。
