Evidence map›Paper›PMID 31722691›Full record

Observational studyBMC palliative care2019

The utility of a shortened palliative care screening tool to predict death within 12 months - a prospective observational study in two south African hospitals with a high HIV burden.

Peter J Raubenheimer, Cascia Day, Faried Abdullah, Katherine Manning, Clint Cupido, Jonny Peter

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMC palliative care, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Review
  4. Article
  5. Patients requiring palliative care attending a regional hospital emergency centre in South Africa: A descriptive study.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2022
    Article
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

6 authors.

Peter J RaubenheimerDivision of General Medicine, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa. peter.raubenheimer@uct.ac.za.ORCID https://orcid.org/0000-0002-5416-1286
Cascia DayDivision of General Medicine, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
Faried AbdullahDivision of General Medicine, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
Katherine ManningDivision of General Medicine, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.
Clint CupidoDivision of General Medicine, Department of Medicine, Victoria Hospital Wynberg and University of Cape Town, Cape Town, South Africa.
Jonny PeterDivision of General Medicine, and Division of Immunology and Allergology, Department of Medicine, Groote Schuur Hospital and University of Cape Town, Cape Town, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTimely identification of people who are at risk of dying is an important first component of end-of-life care. Clinicians often fail to identify such patients, thus trigger tools have been developed to assist in this process. We aimed to evaluate the performance of a identification tool (based on the Gold Standards Framework Prognostic Indicator Guidance) to predict death at 12 months in a population of hospitalised patients in South Africa.

methodsPatients admitted to the acute medical services in two public hospitals in Cape Town, South Africa were enrolled in a prospective observational study. Demographic data were collected from patients and patient notes. Patients were assessed within two days of admission by two trained clinicians who were not the primary care givers, using the identification tool. Outcome mortality data were obtained from patient folders, the hospital electronic patient management system and the Western Cape Provincial death registry which links a unique patient identification number with national death certificate records and system wide electronic records.

results822 patients (median age of 52 years), admitted with a variety of medical conditions were assessed during their admission. 22% of the cohort were HIV-infected. 218 patients were identified using the screening tool as being in the last year of their lives. Mortality in this group was 56% at 12 months, compared with 7% for those not meeting any criteria. The specific indicator component of the tool performed best in predicting death in both HIV-infected and HIV-uninfected patients, with a sensitivity of 74% (68-81%), specificity of 85% (83-88%), a positive predictive value of 56% (49-63%) and a negative predictive value of 93% (91-95%). The hazard ratio of 12-month mortality for those identified vs not was 11.52 (7.87-16.9, p < 0.001).

conclusionsThe identification tool is suitable for use in hospitals in low-middle income country setting that have both a high communicable and non-communicable disease burden amongst young patients, the majority under age 60.

Indexed as

Acute Coronary SyndromeAdultAgedAged, 80 and overCommunicable DiseasesFemaleHIV InfectionsHospitals, PublicHumansKaplan-Meier EstimateMaleMiddle AgedNoncommunicable DiseasesPalliative CarePrognosisProspective StudiesClinical decision-makingHospitilizationPalliative carePrognosis

Identifiers

PMID31722691
PMCPMC6854790

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

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.