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Prognosticating in patients with advanced cancer--observational study comparing the accuracy of clinicians' and patients' estimates of survival.

Gwilliam, B; Keeley, V; Todd, C; Roberts, C; Gittins, M; Kelly, L; Barclay, S; Stone, P

Annals of oncology : official journal of the European Society for Medical Oncology / ESMO. 2012;:1-7.

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Abstract

BackgroundClinicians' prognoses in patients with advanced cancer are imprecise. The aim of this study was to compare doctors', nurses' and patients' survival predictions and to identify factors which influence accuracy.Patients and methodsSome 1018 patients with advanced cancer were recruited. Survival estimates were obtained from the attending doctor, nurse, multidisciplinary team (MDT) and patient (n = 829, 954, 987 and 290 estimates, respectively) and were compared with actual survival. Clinician and patient characteristics were recorded.ResultsMDTs', doctors' and nurses' predictions were accurate 57.5%, 56.3% and 55.5% of occasions, respectively. Nurses were less accurate than the MDT (P = 0.007) but were no worse than doctors (P = 0.284). Estimates of clinicians and patients were more optimistic (doctors: 31%; nurses: 34%; MDT: 31.1%; patients: 45.1%) than pessimistic (12.7%, 11%, 11.4% and 2.7%). Nurses' accuracy increased if they had reviewed the patient within 24 h. Most patients (61.4%) wanted to know their prognosis. Only 37.1% were willing to offer an estimate regarding their own survival. Patients' prognostic estimates were less accurate than health care professionals' (P < 0.001).ConclusionsMDTs were better at predicting survival than doctors' or nurses' alone. Patients were substantially worse. Among nurses, recency of review was related to improved prognostic accuracy.

Bibliographic metadata

Type of resource:
Content type:
Publication type:
Published date:
Abbreviated journal title:
ISSN:
Start page:
1
End page:
7
Digital Object Identifier:
10.1093/annonc/mds341
Pubmed Identifier:
23028038
Pii Identifier:
mds341
Access state:
Active

Institutional metadata

University researcher(s):

Record metadata

Manchester eScholar ID:
uk-ac-man-scw:173291
Created by:
Body, Stacey
Created:
5th October, 2012, 13:11:57
Last modified by:
Body, Stacey
Last modified:
5th October, 2012, 13:15:13

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