Evidence map›Paper›PMID 31185804›Full record

ArticlePalliative medicine2019

A brief, patient- and proxy-reported outcome measure in advanced illness: Validity, reliability and responsiveness of the Integrated Palliative care Outcome Scale (IPOS).

Fliss Em Murtagh, Christina Ramsenthaler, Alice Firth, Esther I Groeneveld, Natasha Lovell, Steffen T Simon, Johannes Denzel, Ping Guo, Florian Bernhardt, Eva Schildmann and 5 more

Open access · hybridAbstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Palliative medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 203 papers, 10 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
203citing papers in PubMed, 10 pooled it
36.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

203 citing papers in PubMed, 10 syntheses or guidelines pooled it, 421 citations in OpenAlex.

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  15. Proactive symptom monitoring to initiate timely palliative care for patients with advanced cancer: a randomized controlled trial.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025
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143 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 4 institutions in 2 countries.

Fliss Em Murtagh1 Wolfson Palliative Care Research Centre, Hull York Medical School, University of Hull, Hull, UK.ORCID 0000-0003-1289-3726
Christina Ramsenthaler2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.ORCID 0000-0002-9996-1818
Alice Firth2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.ORCID 0000-0003-0726-0502
Esther I Groeneveld2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.
Natasha Lovell2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.ORCID 0000-0001-6594-799X
Steffen T Simon4 Center for Palliative Medicine, University of Cologne, Cologne, Germany.
Johannes Denzel3 Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
Ping Guo2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.
Florian Bernhardt3 Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
Eva Schildmann3 Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.ORCID 0000-0001-9756-9954
Birgitt van Oorschot5 Interdisciplinary Centre for Palliative Medicine, University Hospital Wuerzburg, Wuerzburg, Germany.
Farina Hodiamont3 Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
Sabine Streitwieser3 Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
Irene J Higginson2 Cicely Saunders Institute of Palliative Care, Policy & Rehabilitation, King's College London, London, UK.
Claudia Bausewein3 Department of Palliative Medicine, University Hospital, Ludwig-Maximilians-University Munich, Munich, Germany.
King's College London · GBLudwig-Maximilians-Universität München · DEUniversitätsklinikum Würzburg · DEUniversity of Cologne · DE

Funding

Department of Health RP-PG-1210-12015
6 · The paper itself

Abstract

backgroundFew measures capture the complex symptoms and concerns of those receiving palliative care.

aimTo validate the Integrated Palliative care Outcome Scale, a measure underpinned by extensive psychometric development, by evaluating its validity, reliability and responsiveness to change.

designConcurrent, cross-cultural validation study of the Integrated Palliative care Outcome Scale - both (1) patient self-report and (2) staff proxy-report versions. We tested construct validity (factor analysis, known-group comparisons, and correlational analysis), reliability (internal consistency, agreement, and test-retest reliability), and responsiveness (through longitudinal evaluation of change). SETTING/

participantsIn all, 376 adults receiving palliative care, and 161 clinicians, from a range of settings in the United Kingdom and Germany.

resultsWe confirm a three-factor structure (Physical Symptoms, Emotional Symptoms and Communication/Practical Issues). Integrated Palliative care Outcome Scale shows strong ability to distinguish between clinically relevant groups; total Integrated Palliative care Outcome Scale and Integrated Palliative care Outcome Scale subscale scores were higher - reflecting more problems - in those patients with 'unstable' or 'deteriorating' versus 'stable' Phase of Illness (F = 15.1, p < 0.001). Good convergent and discriminant validity to hypothesised items and subscales of the Edmonton Symptom Assessment System and Functional Assessment of Cancer Therapy-General is demonstrated. The Integrated Palliative care Outcome Scale shows good internal consistency (α = 0.77) and acceptable to good test-retest reliability (60% of items k

conclusionThe Integrated Palliative care Outcome Scale is a valid and reliable outcome measure, both in patient self-report and staff proxy-report versions. It can assess and monitor symptoms and concerns in advanced illness, determine the impact of healthcare interventions, and demonstrate quality of care. This represents a major step forward internationally for palliative care outcome measurement.

Indexed as

Palliative CarePatient Reported Outcome MeasuresProxySeverity of Illness IndexAgedCross-Cultural ComparisonFemaleGermanyHumansMaleMiddle AgedPsychometricsReproducibility of ResultsSelf ReportUnited KingdomOutcome and process assessmentpalliative carepatient-reported outcome measurespsychometricsreliabilitysymptom assessmentvalidation studies

Identifiers

PMID31185804
PMCPMC6691591
OpenAlexW2950519345

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.