Prognosticating in palliative care: a survey of Canadian palliative care physicians

To determine how palliative care physicians view the accuracy and importance of prognostication, what information they consider, and what processes they use.

A questionnaire was sent to members of the Canadian Society of Palliative Care Physicians (CSPCP). Respondents recorded their perceptions about prognostication and the factors they considered when predicting survival. A patient scenario was described in which a prognosis was requested by two different people: a patient's daughter and a palliative care admissions coordinator.

90 responses were received from 219 CSPCP members (41.1 percent). There was moderate agreement between respondents' perceptions of their own accuracy and that of other physicians (K = 0.549). Of all the respondents, 89.9 percent believed that prognosticating was somewhat or very important. They considered clinical factors most commonly when prognosticating. A range of predictions was given for the scenario; often, the same physician gave different answers to the two people requesting a prognosis.

Palliative care physicians believe that prognostication is important and use clinical factors to estimate survival. They often give different estimates to different information recipients.