Accurate life expectancy prediction possible

Scoring system helps clinicians recommend care

A new scoring system that can more accurately predict the life expectancy of a patient with advanced cancer in terms of "days," "weeks," and "months" is described in an article published in BMJ.1

This information is significant for clinicians as they evaluate appropriate care for terminally ill cancer patients. Current survival predictions based on clinicians' opinions are often unreliable, over-optimistic, and subjective, according to the authors. Researchers at St George's University of London developed a scoring system for patients with advanced cancer in different care settings that was as good or better than clinicians' best predictions.

The researchers evaluated 1,018 patients with advanced incurable cancer who no longer received treatment, and were recently referred to palliative care services across the United Kingdom. To predict patients' remaining life expectancy in "days" (0-13 days), "weeks" (14-55 days), or "months" (more than 55 days), the team developed two prognostic scores (PiPS-A and PiPS-B) by using a combination of clinical and laboratory variables and compared these with actual survival and clinicians' predictions.

They found that both scores were at least as accurate as a clinician's estimate but PiPS-B, which required a blood test, proved to be significantly more precise than an individual doctor's or nurse's prediction.

According to the authors, this study is the first to benchmark a prognostic scoring system against current best practice, but further validation work is required before recommending the scales to be used in routine clinical practice.

Reference

1. Gwilliam B, Keeley V, Todd C, et. al. Development of Prognosis in Palliative care Study (PiPS) predictor models to improve prognostication in advanced cancer: Prospective cohort study. BMJ 2011;343:d4920.