title: Prospective comparison of prognostic scores in palliative care cancer populations.
abstract: OBJECTIVE
  Predicting prognosis in advanced cancer aids physicians in clinical decision making and can help patients and their families to prepare for the time ahead.
  
  
  METHODS
  This multicenter, observational, prospective, nonrandomized population-based study evaluated life span prediction of four prognostic scores used in palliative care: the original palliative prognostic score (PaP Score), a variant of PaP Score including delirium (D-PaP Score), the Palliative Performance Scale, and the Palliative Prognostic Index.
  
  
  RESULTS
  A total of 549 patients were enrolled onto the study. Median survival of the entire group was 22 days (95% confidence intervals [95% CI] = 19-24). All four prognostic models discriminated well between groups of patients with different survival probabilities. Log-rank tests were all highly significant (p < .0001). The PaP and D-PaP scores were the most accurate, with a C index of 0.72 (95% CI = 0.70-0.73) and 0.73 (95% CI = 0.71-0.74), respectively.
  
  
  CONCLUSIONS
  It can be confirmed that all four prognostic scores used in palliative care studies accurately identify classes of patients with different survival probabilities. The PaP Score has been extensively validated and shows high accuracy and reproducibility in different settings.
authors.affiliation: Palliative Care Clinic, Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (I.R.S.T.), Via P. Maroncelli 40, 47014 Meldola (FC), Italy. ma.maltoni@ausl.fo.it
authors.forename: Marco
authors.initials: M
authors.lastname: Maltoni
authors.forename: Emanuela
authors.initials: E
authors.lastname: Scarpi
authors.forename: Cristina
authors.initials: C
authors.lastname: Pittureri
authors.forename: Francesca
authors.initials: F
authors.lastname: Martini
authors.forename: Luigi
authors.initials: L
authors.lastname: Montanari
authors.forename: Elena
authors.initials: E
authors.lastname: Amaducci
authors.forename: Stefania
authors.initials: S
authors.lastname: Derni
authors.forename: Laura
authors.initials: L
authors.lastname: Fabbri
authors.forename: Marta
authors.initials: M
authors.lastname: Rosati
authors.forename: Dino
authors.initials: D
authors.lastname: Amadori
authors.forename: Oriana
authors.initials: O
authors.lastname: Nanni
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000401:mortality* / Q000473:pathology; D010166:Palliative Care; D011379:Prognosis; D011446:Prospective Studies; D013727:Terminal Care