Independent validation of the modified prognosis palliative care study predictor models in three palliative care settings

Mika Baba; Isseki Maeda; Tatsuya Morita; Takayuki Hisanaga; Tatsuhiko Ishihara; Tomoyuki Iwashita; Keisuke Kaneishi; Shohei Kawagoe; Toshiyuki Kuriyama; Takashi Maeda; Ichiro Mori; Nobuhisa Nakajima; Tomohiro Nishi; Hiroki Sakurai; Satofumi Shimoyama; Takuya Shinjo; Hiroto Shirayama; Takeshi Yamada; Shigeki Ono; Taketoshi Ozawa; Ryo Yamamoto; Satoru Tsuneto

doi:10.1016/j.jpainsymman.2014.10.010

Independent validation of the modified prognosis palliative care study predictor models in three palliative care settings

J Pain Symptom Manage. 2015 May;49(5):853-60. doi: 10.1016/j.jpainsymman.2014.10.010. Epub 2014 Dec 12.

Authors

Mika Baba¹, Isseki Maeda², Tatsuya Morita³, Takayuki Hisanaga⁴, Tatsuhiko Ishihara⁵, Tomoyuki Iwashita⁶, Keisuke Kaneishi⁷, Shohei Kawagoe⁸, Toshiyuki Kuriyama⁹, Takashi Maeda¹⁰, Ichiro Mori¹¹, Nobuhisa Nakajima¹², Tomohiro Nishi¹³, Hiroki Sakurai¹⁴, Satofumi Shimoyama¹⁵, Takuya Shinjo¹⁶, Hiroto Shirayama¹⁷, Takeshi Yamada¹⁸, Shigeki Ono¹⁹, Taketoshi Ozawa²⁰, Ryo Yamamoto²¹, Satoru Tsuneto²²

Affiliations

¹ Department of Palliative Care, Saito Yukoukai Hospital, Ibaragi, Osaka, Japan. Electronic address: baba@saito-yukoukai-hp.jp.
² Department of Palliative Medicine, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
³ Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu City, Shizuoka, Japan.
⁴ Tsukuba Medical Center Foundation, Tsukuba, Ibaraki, Japan.
⁵ Palliative Care Department, Okayama Saiseikai General Hospital, Okayama City, Okayama, Japan.
⁶ Matsue City Hospital, Matsue City, Shimane, Japan.
⁷ Department of Palliative Care Unit, JCHO Tokyo Shinjuku Medical Center, Shinjuku, Tokyo, Japan.
⁸ Aozora Clinic, Matsudo-city, Chiba, Japan.
⁹ Department of Palliative Medicine, Wakayama Medical University Hospital Oncology Center, Kimiidera, Wakayama, Japan.
¹⁰ Department of Palliative Care, Tokyo Metropolitan Cancer and Infectious Disease Center, Komagome Hospital, Bunkyo-ku, Tokyo, Japan.
¹¹ Gratia Hospital Hospice, Mino, Osaka, Japan.
¹² Department of Palliative Medicine, Graduate School of Medicine, Tohoku University, Sendai, Miyagi, Japan.
¹³ Kawasaki Comprehensive Care Center, Kawasaki Municipal Ida Hospital, Nakahara-ku, Kanagawa, Japan.
¹⁴ Department of Palliative Care, St. Luke's International Hospital, Chuo-ku, Tokyo, Japan.
¹⁵ Department of Palliative Care, Aichi Cancer Center Hospital, Chikusa-ku, Nagoya, Japan.
¹⁶ Shinjo Clinic, Kobe, Hyogo, Japan.
¹⁷ Iryouhoujinn Takumikai Osaka Kita Homecare Clinic, Osaka City, Osaka, Japan.
¹⁸ Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery, Nippon Medical School, Bunkyo-ku, Tokyo, Japan.
¹⁹ Division of Palliative Medicine, Shizuoka Cancer Center Hospital, Suntou-gun, Shizuoka, Japan.
²⁰ Megumi Zaitaku Clinic, Yokohama-shi, Kanagawa, Japan.
²¹ Department of Palliative Medicine, Saku Central Hospital Advanced Care Center, Saku-shi, Nagano, Japan.
²² Department of Multidisciplinary Cancer Treatment, Graduate School of Medicine, Kyoto University, Sakyo-ku, Kyoto, Japan.

PMID: 25499420
DOI: 10.1016/j.jpainsymman.2014.10.010

Abstract

Context: Accurate prognostic information in palliative care settings is needed for patients to make decisions and set goals and priorities. The Prognosis Palliative Care Study (PiPS) predictor models were presented in 2011, but have not yet been fully validated by other research teams.

Objectives: The primary aim of this study is to examine the accuracy and to validate the modified PiPS (using physician-proxy ratings of mental status instead of patient interviews) in three palliative care settings, namely palliative care units, hospital-based palliative care teams, and home-based palliative care services.

Methods: This multicenter prospective cohort study was conducted in 58 palliative care services including 16 palliative care units, 19 hospital-based palliative care teams, and 23 home-based palliative care services in Japan from September 2012 through April 2014.

Results: A total of 2426 subjects were recruited. For reasons including lack of followup and missing variables (primarily blood examination data), we obtained analyzable data from 2212 and 1257 patients for the modified PiPS-A and PiPS-B, respectively. In all palliative care settings, both the modified PiPS-A and PiPS-B identified three risk groups with different survival rates (P<0.001). The absolute agreement ranged from 56% to 60% in the PiPS-A model and 60% to 62% in the PiPS-B model.

Conclusion: The modified PiPS was successfully validated and can be useful in palliative care units, hospital-based palliative care teams, and home-based palliative care services.

Keywords: Prognosis palliative care study predictor models; modified; palliative setting; prognostic score; validation study.

Publication types

Comparative Study
Evaluation Study
Multicenter Study
Research Support, Non-U.S. Gov't
Validation Study

MeSH terms

Aged
Ambulatory Care / statistics & numerical data*
Critical Illness / mortality*
Critical Illness / therapy*
Female
Home Care Services / statistics & numerical data*
Hospitalization / statistics & numerical data*
Humans
Japan / epidemiology
Male
Outcome Assessment, Health Care / methods
Outcome Assessment, Health Care / statistics & numerical data
Palliative Care / statistics & numerical data*
Prevalence
Prognosis
Reproducibility of Results
Risk Assessment / methods
Sensitivity and Specificity
Survival Analysis
Treatment Outcome