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Prospective Validation of the Objective Prognostic Score for Advanced Cancer Patients in Diverse Palliative Settings
Hyun Jung Jho1, Sang-Yeon Suh2, Seok-Joon Yoon3
1Palliative Care Clinic, Hospital, National Cancer Center, Goyang, South Korea.
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.
