Abstract:
BACKGROUND:The Surprise Question ("Would I be surprised if this patient were to die within the next 12 months?") is widely used to identify palliative patients, though with low predictive value. To improve timely identification of palliative care needs, we propose an additional Surprise Question ("Would I be surprised if this patient is still alive after 12 months?") if the original Surprise Question is answered with "no." The combination of the two questions is called the Double Surprise Question. AIM:To examine the prognostic accuracy of the Double Surprise Question in outpatients with cancer. DESIGN:A prospective study. PARTICIPANTS:Twelve medical oncologists completed the Double Surprise Question for 379 patients. RESULTS:In group 1 (original Surprise Question "yes": surprised if dead) 92.1% (176/191) of the patients were still alive after 1 year, in group 2a (original and additional Surprise Question "no": not surprised if dead and not surprised if alive) 60.0% (63/105), and in group 2b (original Surprise Question "no," additional Surprise Question "yes": surprised if alive) 26.5% (22/83) (p < 0.0001). The positive predictive value increased by using the Double Surprise Question; 74% (61/83) vs 55% (103/188). Anticipatory palliative care provision and Advance Care Planning items were most often documented in group 2b. CONCLUSIONS:The Double Surprise Question is a promising tool to more accurately identify outpatients with cancer at risk of dying within 1 year, and therefore, those in need of palliative care. Studies should reveal whether the implementation of the Double Surprise Question leads to more timely palliative care.
journal_name
Palliat Medjournal_title
Palliative medicineauthors
Ermers DJ,Kuip EJ,Veldhoven C,Schers HJ,Perry M,Bronkhorst EM,Vissers KC,Engels Ydoi
10.1177/0269216320986720subject
Has Abstractpub_date
2021-01-11 00:00:00pages
269216320986720eissn
0269-2163issn
1477-030Xpub_type
杂志文章abstract::Using Grounded Theory, this study examines the experience of 19 palliative care chaplains in counselling dying people. Taking a broad-based definition of counselling, and using unstructured individual interviews and group work, the study aimed to understand how palliative care chaplains work with patients at the point...
journal_title:Palliative medicine
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