title: Validation of the Simplified Palliative Prognostic Index Using a Single Item From the Communication Capacity Scale.
abstract: BACKGROUND
  Although the Palliative Prognostic Index (PPI) is a reliable and validated tool to predict the survival of terminally ill cancer patients, all clinicians cannot always precisely diagnose delirium.
  
  
  OBJECTIVE
  The primary aim of this study was to examine the predictive value of a simplified PPI. In the simplified PPI, a single item from the Communication Capacity Scale was substituted for the delirium item of the original.
  
  
  METHODS
  This multicenter prospective cohort study was conducted in Japan from September 2012 through April 2014 and involved 16 palliative care units, 19 hospital-based palliative care teams, and 23 home-based palliative care services. Palliative care physicians recorded clinical variables at the first assessment and followed up patients six months later.
  
  
  RESULTS
  A total of 2425 subjects were recruited; 2343 had analyzable data. The C-statistics of the original and simplified PPIs were 0.801 and 0.800 for three week and 0.800 and 0.781 for six-week survival predictions, respectively. The sensitivity and specificity for survival predictions using the simplified PPI were 72.9% and 67.6% (for three week) and 80.3% and 61.8% (for six week), respectively.
  
  
  CONCLUSIONS
  The simplified PPI showed essentially the same predictive value as the original PPI and is an alternative when clinicians have difficulties in diagnosing delirium.
authors.affiliation: Division of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Hamano
authors.affiliation: Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan.
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.affiliation: Megumi Zaitaku Clinic, Yokohama, Kanagawa, Japan.
authors.forename: Taketoshi
authors.initials: T
authors.lastname: Ozawa
authors.affiliation: Shishido Internal Medicine Clinic, Sakura, Chiba, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Shishido
authors.affiliation: Soshukai Okabe Clinic, Natori-shi, Miyagi, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Kawahara
authors.affiliation: Sakanoue Family Clinic, Hamamatsu, Shizuoka, Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Aoki
authors.affiliation: Demizu Clinic, Kishiwada-shi, Osaka, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Demizu
authors.affiliation: Homecare Clinic Kobe, Kobe, Hyogo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Goshima
authors.affiliation: Himawari Zaitaku Clinic, Kumamoto-shi, Kumamoto, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Goto
authors.affiliation: Kanamecho Home Care Clinic, Tokyo, Tokyo, Japan.
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Gyoda
authors.affiliation: Fukushima Home Palliative Care Clinic, Fukushima-shi, Fukushima, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Hashimoto
authors.affiliation: Shonan International Village Clinic, Hayama, Kanagawa, Japan.
authors.forename: Sen
authors.initials: S
authors.lastname: Otomo
authors.affiliation: Sekimoto Clinic, Kobe, Hyogo, Japan.
authors.forename: Masako
authors.initials: M
authors.lastname: Sekimoto
authors.affiliation: Kanwakeakurinikku-Eniwa, Eniwa, Hokkaido, Japan.
authors.forename: Takemi
authors.initials: T
authors.lastname: Shibata
authors.affiliation: Sugimoto Homecare Clinic, Nagoya, Aichi, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Sugimoto
authors.affiliation: Senri Pain Clinic, Toyonaka City, Osaka, Japan.
authors.forename: Mikako
authors.initials: M
authors.lastname: Matsunaga
authors.affiliation: Hidamari Clinic, Takasaki City, Gunma, Japan.
authors.forename: Yukihiko
authors.initials: Y
authors.lastname: Takeda
authors.affiliation: Peace Clinic Nakai, Nakai, Kanagawa, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nagayama
authors.affiliation: Department of Palliative Medicine, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. Electronic address: hikinosh@east.ncc.go.jp.
authors.forename: Hiroya
authors.initials: H
authors.lastname: Kinoshita
mesh_terms: D000368:Aged; D003142:Communication; D003693:Delirium / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006699:Home Care Services; D006761:Hospitals; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D010166:Palliative Care / Q000379:methods*; D011379:Prognosis; D011446:Prospective Studies; D011581:Psychological Tests; D012680:Sensitivity and Specificity
keywords: Communication Capacity Scale; Palliative Prognostic Index; delirium