Prospective Validation of the Objective Prognostic Score for Advanced Cancer Patients in Diverse Palliative Settings

J Pain Symptom Manage. 2016 Sep;52(3):420-7. doi: 10.1016/j.jpainsymman.2016.03.015. Epub 2016 Jul 4.

Abstract

Context: Prognostication is an essential part of palliative care to aid decision making and negotiate goals of care. The Objective Prognostic Score (OPS) is an easy-to-use prognosticating tool to predict survival among far-advanced cancer patients in palliative care units (PCUs) in Korea.

Objectives: This study aimed to prospectively validate the OPS for advanced cancer patients in the palliative care teams (PCTs), PCUs, and home-based palliative care (HPC) in Japan.

Methods: This was a substudy of a multicenter prospective cohort study that was conducted to validate and compare prognostic tools among advanced cancer patients in Japan. Participants' survival was calculated according to OPS 3 as a cutoff for predicting survival of less than three weeks. Overall accuracy and area under the receiver operator characteristic curves of OPS 3 were calculated for PCT, PCU, and HPC, respectively.

Results: A total of 1146 cases (PCTs 441, PCUs 519, and HPCs 186 cases) were included in final analyses. The overall accuracy of OPS 3 for predicting three-week survival ranged from 0.70 to 0.78 across diverse palliative care settings. The c-statistics ranged from 0.742 to 0.808 across three settings. Participants in the PCT showed the highest overall accuracy and c-statistics for OPS.

Conclusion: The OPS can be used for prognostication among advanced cancer patients in PCT, PCU, and HPC settings.

Keywords: Cancer; Objective Prognostic Score; palliative care; prognostication; survival.

Publication types

  • Multicenter Study
  • Validation Study

MeSH terms

  • Aged
  • Area Under Curve
  • Biomarkers / metabolism
  • Female
  • Home Care Services
  • Humans
  • Japan
  • Male
  • Neoplasms / diagnosis*
  • Palliative Care*
  • Patient Care Team
  • Prognosis
  • Prospective Studies
  • ROC Curve
  • Survival Analysis

Substances

  • Biomarkers