Prediction of patient survival by healthcare professionals in a specialist palliative care inpatient unit: a prospective study.
Accurate prognostication is an enormous challenge for professionals caring for patients with advanced disease. Few studies have compared the prognostic accuracy of different professional groups within a hospice setting. The aim of this study was to compare the ability of 5 professional groups to estimate the survival of patients admitted to a specialist palliative care unit. No group accurately predicted the length of patient survival more than 50% of the time. Nursing and junior medical staff were most accurate while care assistants were least accurate. When in error, senior clinical staff tended to under-estimate survival. Independent mobility on admission was the only variable predictive of length of survival. Thus, professional groups differ in their prognostic accuracy. An awareness of a group's propensity to over- or under-estimate prognosis should be incorporated into future work on prognostication models.
Twomey
Feargal
F
Marymount Hospice, St Patrick's Hospital, Wellington Road, Cork, Ireland. uatuama1@ireland.com
O'Leary
Norma
N
O'Brien
Tony
T
D000368:Aged; D001291:Attitude of Health Personnel; D015982:Bias; D002983:Clinical Competence / Q000592:standards*; D003253:Consultants / Q000523:psychology; D005260:Female; D006801:Humans; D007297:Inpatients / Q000145:classification / Q000706:statistics & numerical data; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008503:Medical Staff / Q000523:psychology; D051346:Mobility Limitation; D009718:Nurse Administrators / Q000523:psychology; D009730:Nursing Assessment / Q000592:standards; D009728:Nursing Assistants / Q000523:psychology; D015403:Nursing Evaluation Research; D009740:Nursing Staff / Q000523:psychology; D010166:Palliative Care / Q000458:organization & administration*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment / Q000592:standards; D013997:Time Factors