title: Meta-analysis of survival prediction with Palliative Performance Scale.
abstract: This paper aims to reconcile the use of Palliative Performance Scale (PPSv2) for survival prediction in palliative care through an international collaborative study by five research groups. The study involves an individual patient data meta-analysis on 1,808 patients from four original datasets to reanalyze their survival patterns by age, gender, cancer status, and initial PPS score. Our findings reveal a strong association between PPS and survival across the four datasets. The Kaplan-Meier survival curves show each PPS level as distinct, with a strong ordering effect in which higher PPS levels are associated with increased length of survival. Using a stratified Cox proportional hazard model to adjust for study differences, we found females lived significantly longer than males, with a further decrease in hazard for females not diagnosed with cancer. Further work is needed to refine the reporting of survival times/probabilities and to improve prediction accuracy with the inclusion of other variables in the models.
authors.affiliation: Division of Palliative Care, University of British Columbia.
authors.forename: Michael
authors.initials: M
authors.lastname: Downing
authors.forename: Francis
authors.initials: F
authors.lastname: Lau
authors.forename: Mary
authors.initials: M
authors.lastname: Lesperance
authors.forename: Nicholas
authors.initials: N
authors.lastname: Karlson
authors.forename: Jack
authors.initials: J
authors.lastname: Shaw
authors.forename: Craig
authors.initials: C
authors.lastname: Kuziemsky
authors.forename: Steve
authors.initials: S
authors.lastname: Bernard
authors.forename: Laura
authors.initials: L
authors.lastname: Hanson
authors.forename: Lola
authors.initials: L
authors.lastname: Olajide
authors.forename: Barbara
authors.initials: B
authors.lastname: Head
authors.forename: Christine
authors.initials: C
authors.lastname: Ritchie
authors.forename: Joan
authors.initials: J
authors.lastname: Harrold
authors.forename: David
authors.initials: D
authors.lastname: Casarett
mesh_terms: D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada / Q000453:epidemiology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D010166:Palliative Care; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D015203:Reproducibility of Results; D012107:Research Design; D012189:Retrospective Studies; D012720:Severity of Illness Index; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology