1. Clinicians' Prediction of Survival and Prognostic Confidence in Patients with Advanced Cancer in Three East Asian Countries.
- Author
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Lee, Eon Sook, Hiratsuka, Yusuke, Suh, Sang-Yeon, Won, Seon-Hye, Kim, Sun-Hyun, Yoon, Seok-Joon, Choi, Sung-Eun, Choi, Hana, Ahn, Hong-Yup, Kim, Yoonjoo, Hui, David, Cheng, Shao-Yi, Chen, Ping-Jen, Wu, Chien-Yi, Mori, Masanori, Morita, Tatsuya, Yamaguchi, Takashi, and Tsuneto, Satoru
- Subjects
PREDICTION models ,PALLIATIVE treatment ,RECEIVER operating characteristic curves ,RESEARCH funding ,EAST Asians ,RESEARCH evaluation ,DECISION making in clinical medicine ,CONFIDENCE ,CANCER patients ,LONGITUDINAL method ,SURVIVAL analysis (Biometry) ,TUMORS ,SENSITIVITY & specificity (Statistics) - Abstract
Background: Little is known about accuracy and confidence of clinicians' prediction of survival (CPS) in East-Asian countries. Objective: We aimed to examine accuracy of CPS for 7-, 21-, and 42-day survival in palliative inpatients and its association with prognostic confidence. Design: An international prospective cohort study in Japan (JP), Korea (KR), and Taiwan (TW). Setting/Subjects: Subjects were inpatients with advanced cancer admitted to 37 palliative care units in three countries. Measurements: Discrimination of CPS was investigated through sensitivity, specificity, overall accuracy, and area under the receiver operating characteristics curves (AUROCs) according to 7-, 21-, and 42-day survival. The accuracies of CPS were compared with those of Performance Status-based Palliative Prognostic Index (PS-PPI). Clinicians were instructed to rate confidence level on a 0–10-point scale. Results: A total of 2571 patients were analyzed. The specificity was highest at 93.2–100.0% for the 7-day CPS, and sensitivity was highest at 71.5–86.8% for the 42-day CPS. The AUROCs of the seven-day CPS were 0.88, 0.94, and 0.89, while those of PS-PPI were 0.77, 0.69, and 0.69 for JP, KR, and TW, respectively. As for 42-day prediction, sensitivities of PS-PPI were higher than those of CPS. Clinicians' confidence was strongly associated with the accuracy of prediction in all three countries (all p-values <0.01). Conclusions: CPS accuracies were highest (0.88–0.94) for the seven-day survival prediction. CPS was more accurate than PS-PPI in all timeframe prediction except 42-day prediction in KR. Prognostic confidence was significantly associated with the accuracy of CPS. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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