Yusuke Hiratsuka1,2, Seok-Joon Yoon3, Sang-Yeon Suh4,5, Sung-Eun Choi6, David Hui7, Sun-Hyun Kim8, Eon Sook Lee9, Sun Wook Hwang10, Shao-Yi Cheng11, Ping-Jen Chen12,13, Masanori Mori14, Takashi Yamaguchi15, Tatsuya Morita14, Satoru Tsuneto16, Akira Inoue2. 1. Department of Palliative Medicine, Takeda General Hospital, Aizu Wakamatsu, Japan. 2. Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan. 3. Department of Family Medicine, Chungnam National University Hospital, Daejeon, South Korea. 4. Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang, Gyeonggi-do, South Korea. lisasuhmd@hotmail.com. 5. Department of Medicine, Dongguk University Medical School, Pildong 1-30, Jung-gu, Seoul, South Korea. lisasuhmd@hotmail.com. 6. Department of Statistics, Dongguk University, Seoul, South Korea. 7. Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. 8. Department of Family Medicine, School of Medicine, Catholic Kwandong University International St. Mary's Hospital, Incheon, South Korea. 9. Department of Family Medicine, Ilsan-Paik Hospital, College of Medicine, Inje University, Goyang, South Korea. 10. Department of Family Medicine, Eunpyeong St. Mary's Hospital, The Catholic University of Korea, Seoul, South Korea. 11. Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan. 12. Department of Family Medicine, Kaohsiung Medical University Hospital, and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. 13. Division of Psychiatry, Marie Curie Palliative Care Research Department, University College London, London, UK. 14. Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan. 15. Division of Palliative Care, Konan Medical Center, Kobe, Japan. 16. Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Abstract
PURPOSE: No study has been conducted to compare the clinicians' prediction of survival (CPS) with Palliative Prognostic Scores (PaP) across countries. We aimed to compare the performance of the CPS in PaP (PaP-CPS), the PaP without the CPS, and the PaP total scores in patients with advanced cancer in three East Asian countries. METHODS: We compared the discriminative accuracy of the three predictive models (the PaP-CPS [the score of the categorical CPS of PaP], the PaP without the CPS [sum of the scores of only the objective variables of PaP], and the PaP total score) in patients admitted to palliative care units (PCUs) in Japan, Korea, and Taiwan. We calculated the area under the receiver operating characteristic curve (AUROC) for 30-day survival to compare the discriminative accuracy of these three models. RESULTS: We analyzed 2,072 patients from three countries. The AUROC for the PaP total scores was 0.84 in patients in Japan, 0.76 in Korea, and 0.79 in Taiwan. The AUROC of the PaP-CPS was 0.82 in patients in Japan, 0.75 in Korea, and 0.78 in Taiwan. The AUROC of the PaP without the CPS was 0.75 in patients in Japan, 0.66 in Korea, and 0.67 in Taiwan. CONCLUSION: The PaP total scores and the PaP-CPS consistently showed similar discriminative accuracy in predicting 30-day survival in patients admitted to PCUs in Japan, Korea, and Taiwan. It may be sufficient for experienced clinicians to use the CPS alone for estimating the short-term survival (less than one month) of patients with far-advanced cancer. The PaP may help to improve prognostic confidence and further reduce subjective variations.
PURPOSE: No study has been conducted to compare the clinicians' prediction of survival (CPS) with Palliative Prognostic Scores (PaP) across countries. We aimed to compare the performance of the CPS in PaP (PaP-CPS), the PaP without the CPS, and the PaP total scores in patients with advanced cancer in three East Asian countries. METHODS: We compared the discriminative accuracy of the three predictive models (the PaP-CPS [the score of the categorical CPS of PaP], the PaP without the CPS [sum of the scores of only the objective variables of PaP], and the PaP total score) in patients admitted to palliative care units (PCUs) in Japan, Korea, and Taiwan. We calculated the area under the receiver operating characteristic curve (AUROC) for 30-day survival to compare the discriminative accuracy of these three models. RESULTS: We analyzed 2,072 patients from three countries. The AUROC for the PaP total scores was 0.84 in patients in Japan, 0.76 in Korea, and 0.79 in Taiwan. The AUROC of the PaP-CPS was 0.82 in patients in Japan, 0.75 in Korea, and 0.78 in Taiwan. The AUROC of the PaP without the CPS was 0.75 in patients in Japan, 0.66 in Korea, and 0.67 in Taiwan. CONCLUSION: The PaP total scores and the PaP-CPS consistently showed similar discriminative accuracy in predicting 30-day survival in patients admitted to PCUs in Japan, Korea, and Taiwan. It may be sufficient for experienced clinicians to use the CPS alone for estimating the short-term survival (less than one month) of patients with far-advanced cancer. The PaP may help to improve prognostic confidence and further reduce subjective variations.
Authors: Stephanie Cheon; Arnav Agarwal; Marko Popovic; Milica Milakovic; Michael Lam; Wayne Fu; Julia DiGiovanni; Henry Lam; Breanne Lechner; Natalie Pulenzas; Ronald Chow; Edward Chow Journal: Ann Palliat Med Date: 2016-01