OBJECTIVE: There is little information about the accuracy of patient perceptions of their life expectancy. Here, we compare patient perceptions of their outlook and their oncologist's estimates of life expectancy to actual survival. METHODS: The Unmet Needs Study recruited patients with metastatic cancer. Oncologists were asked to estimate patient survival as: (1) weeks; (2) months; (3) <1 year; (4)<2 years; and (5) >2 years. Patients were asked to estimate their outlook on a numerical scale from 1-7. Patient and oncologist estimates were compared with actual survival. RESULTS: Complete survival data were available for 50 patients: median age 63.5 years; 48% male; tumor types: 32% colorectal, 24% lung, 10% upper gastrointestinal cancer, 12% unknown primary; and median survival 6.8 months. The oncologists were 32% accurate in predicting survival and overestimated survival 42% of the time (weighted kappa=0.34). The correlation between self-reported patient outlook and survival was modest (Spearman's rho=0.36, p=0.01). The median survival for categories of outlook of 1-3, 4-5, and 6-7 were 4.4, 5.4, and 14.8 months, respectively (p=0.01). Overseas-born patient was the only independent predictor for the oncologists' accurate estimates (p=0.01). CONCLUSIONS: Oncologists were relatively poor at predicting survival and tended to be optimistic in their prognostication. The probability of survival significantly decreased with worse self-reported patient outlook.
OBJECTIVE: There is little information about the accuracy of patient perceptions of their life expectancy. Here, we compare patient perceptions of their outlook and their oncologist's estimates of life expectancy to actual survival. METHODS: The Unmet Needs Study recruited patients with metastatic cancer. Oncologists were asked to estimate patient survival as: (1) weeks; (2) months; (3) <1 year; (4)<2 years; and (5) >2 years. Patients were asked to estimate their outlook on a numerical scale from 1-7. Patient and oncologist estimates were compared with actual survival. RESULTS: Complete survival data were available for 50 patients: median age 63.5 years; 48% male; tumor types: 32% colorectal, 24% lung, 10% upper gastrointestinal cancer, 12% unknown primary; and median survival 6.8 months. The oncologists were 32% accurate in predicting survival and overestimated survival 42% of the time (weighted kappa=0.34). The correlation between self-reported patient outlook and survival was modest (Spearman's rho=0.36, p=0.01). The median survival for categories of outlook of 1-3, 4-5, and 6-7 were 4.4, 5.4, and 14.8 months, respectively (p=0.01). Overseas-born patient was the only independent predictor for the oncologists' accurate estimates (p=0.01). CONCLUSIONS: Oncologists were relatively poor at predicting survival and tended to be optimistic in their prognostication. The probability of survival significantly decreased with worse self-reported patient outlook.
Authors: Sara Mandelli; Emma Riva; Mauro Tettamanti; Ugo Lucca; Davide Lombardi; Gianmaria Miolo; Simon Spazzapan; Rita Marson Journal: Support Care Cancer Date: 2020-08-31 Impact factor: 3.603
Authors: David A Alter; Dennis T Ko; Jack V Tu; Therese A Stukel; Douglas S Lee; Andreas Laupacis; Alice Chong; Peter C Austin Journal: J Gen Intern Med Date: 2012-05-02 Impact factor: 5.128
Authors: Mellar P Davis; Erin A Vanenkevort; Alexander Elder; Amanda Young; Irina D Correa Ordonez; Mark J Wojtowicz; Halle Ellison; Carlos Fernandez; Zankhana Mehta; Bertrand Behm; Glen Digwood; Rajiv Panikkar Journal: Support Care Cancer Date: 2022-03-15 Impact factor: 3.603