ArticleBMC palliative care2019
Screening with the double surprise question to predict deterioration and death: an explorative study.
Article 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 15 papers, 2 of them syntheses that pooled it.
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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.
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.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- The Surprise Question and clinician-predicted prognosis: systematic review and meta-analysis.BMJ supportive & palliative care · 2024Pooled it
- The utility of the surprise question: A useful tool for identifying patients nearing the last phase of life? A systematic review and meta-analysis.Palliative medicine · 2022Pooled it
- Evaluating Palliative Care Needs in Patients with Advanced Non-Malignant Chronic Conditions: An Umbrella Review of Needs Assessment Tools.Healthcare (Basel, Switzerland) · 2025Review
- Process evaluation of prevention in long-term care facilities - resident and therapist perspectives on the benefits and acceptance of preventive speech and swallowing sessions.BMC geriatrics · 2025Article
- Development and testing of a predictive model of symptoms for pain in community-dwelling frail older people in palliative care.BMC palliative care · 2025Observational
- When would I be surprised? Variability in predicted probability of survival for being "surprised" and "not surprised" to the surprise question.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Characteristics of timely integration of palliative care into oncology hospital care for patients with incurable cancer: results of a Delphi Study.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2024Article
- Study protocol of the OrkA project: orofacial and communicative activation in old age- a cluster randomized prevention study in long-term care facilities in Lower Saxony, Germany.BMC geriatrics · 2024Article
- Interrater agreement of multi-professional case review as reference standard for specialist palliative care need: a mixed-methods study.BMC palliative care · 2023Article
- When to initiate early palliative care? Challenges faced by healthcare providers.Frontiers in medicine · 2023Article
- Identifying, exploring and integrating the spiritual dimension in proactive care planning: A mixed methods evaluation of a communication training intervention for multidisciplinary palliative care teams.Palliative medicine · 2022Article
- Article
- External Validation and User Experiences of the ProPal-COPD Tool to Identify the Palliative Phase in COPD.International journal of chronic obstructive pulmonary disease · 2022Article
- Where do GPs find patients with possible palliative care needs? A cross-sectional descriptive study.BJGP open · 2021Article
- Timely identification of patients in need of palliative care using the Double Surprise Question: A prospective study on outpatients with cancer.Palliative medicine · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEarly identification of palliative patients is challenging. The Surprise Question (SQ1; Would I be surprised if this patient were to die within 12 months?) is widely used to identify palliative patients. However, its predictive value is low. Therefore, we added a second question (SQ2) to SQ1: 'Would I be surprised if this patient is still alive after 12 months?' We studied the accuracy of this double surprise question (DSQ) in a general practice.
methodsWe performed a prospective cohort study with retrospective medical record review in a general practice in the eastern part of the Netherlands. Two general practitioners (GPs) answered both questions for all 292 patients aged ≥75 years (mean age 84 years). Primary outcome was 1-year death, secondary outcomes were aspects of palliative care.
resultsSQ1 was answered with 'no' for 161/292 patients. Of these, SQ2 was answered with 'yes' in 22 patients. Within 12 months 26 patients died, of whom 24 had been identified with SQ1 (sensitivity: 92%, specificity: 49%). Ten of them were also identified with SQ2 (sensitivity: 42%, specificity: 91%). The latter group had more contacts with their GP and more palliative care aspects were discussed.
conclusionsThe DSQ appears a feasible and easy applicable screening tool in general practice. It is highly effective in predicting patients in high need for palliative care and using it helps to discriminate between patients with different life expectancies and palliative care needs. Further research is necessary to confirm the findings of this study.
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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.