title: The accuracy of clinicians' predictions of survival in advanced cancer: a review.
abstract: The process of formulating an accurate survival prediction is often difficult but important, as it influences the decisions of clinicians, patients, and their families. The current article aims to review the accuracy of clinicians' predictions of survival (CPS) in advanced cancer patients. A literature search of Cochrane CENTRAL, EMBASE, and MEDLINE was conducted to identify studies that reported clinicians' prediction of survival in advanced cancer patients. Studies were included if the subjects consisted of advanced cancer patients and the data reported on the ability of clinicians to predict survival, with both estimated and observed survival data present. Studies reporting on the ability of biological and molecular markers to predict survival were excluded. Fifteen studies that met the inclusion and exclusion criteria were identified. Clinicians in five studies underestimated patients' survival (estimated to observed survival ratio between 0.5 and 0.92). In contrast, 12 studies reported clinicians' overestimation of survival (ratio between 1.06 and 6). CPS in advanced cancer patients is often inaccurate and overestimated. Given these findings, clinicians should be aware of their tendency to be overoptimistic. Further investigation of predictive patient and clinician characteristics is warranted to improve clinicians' ability to predict survival.
authors: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Stephanie
authors: S
authors: Cheon
authors: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Arnav
authors: A
authors: Agarwal
authors: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Marko
authors: M
authors: Popovic
authors: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Milica
authors: M
authors: Milakovic
authors: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Michael
authors: M
authors: Lam
authors: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Wayne
authors: W
authors: Fu
authors: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Julia
authors: J
authors: DiGiovanni
authors: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Henry
authors: H
authors: Lam
authors: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Breanne
authors: B
authors: Lechner
authors: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Natalie
authors: N
authors: Pulenzas
authors: Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.
authors: Ronald
authors: R
authors: Chow
authors: Department of Radiation Oncology, Odette Cancer Centre, Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, Canada. Edward.Chow@sunnybrook.ca.
authors: Edward
authors: E
authors: Chow
mesh_terms: D002983:Clinical Competence / Q000592:standards*; D015510:Clinical Medicine / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000401:mortality*; D015588:Observer Variation; D011379:Prognosis; D016019:Survival Analysis; D013727:Terminal Care / Q000592:standards
keywords: Advanced cancer; clinical prediction; prognosis; survival