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

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. (C) 2016 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.