ArticleBMJ supportive & palliative care2020
Specialist palliative medicine physicians and nurses accuracy at predicting imminent death (within 72 hours): a short report.
Article in BMJ supportive & palliative care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic evaluation in patients with advanced cancer in the last months of life: ESMO Clinical Practice Guideline.ESMO open · 2023Guideline
- Accuracy of clinician perceptions in estimating patient survival in general medicine.Internal medicine journal · 2026Article
- The impact of nursing care and difficulties training given to nurses on dying cancer patient on quality of care and difficulties: a randomized controlled study.BMC nursing · 2026Article
- Determining timeframes to death for imminently dying patients: a retrospective cohort study.BMC palliative care · 2025Article
- Recognising dying in motor neurone disease: A scoping review.Palliative medicine · 2024Article
- 'How long do you think?' Unresponsive dying patients in a specialist palliative care service: A consecutive cohort study.Palliative medicine · 2024Article
- Accuracy of clinical predictions of prognosis at the end-of-life: evidence from routinely collected data in urgent care records.BMC palliative care · 2023Observational
- Differences in goals of care discussion outcomes among healthcare professionals: an observational cross-sectional study.Palliative medicine · 2022Observational
- Quality of dying in hospital general wards: a cross-sectional study about the end-of-life care.BMC palliative care · 2021Article
- An environmental scan of visitation policies in Canadian intensive care units during the first wave of the COVID-19 pandemic.Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2021Article
- "3-Day Surprise Question" to predict prognosis of advanced cancer patients with impending death: Multicenter prospective observational study.Cancer medicine · 2021Observational
- Paved With Good Intentions: Hospital Visitation Restrictions in the Age of Coronavirus Disease 2019.Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies · 2020Article
Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
objectivesResearch suggests that clinicians are not very accurate at prognosticating in palliative care. The 'horizon effect' suggests that accuracy ought to be better when the survival of patients is shorter. The aim of this study was to determine the accuracy of specialist palliative care clinicians at identifying which patients are likely to die within 72 hours.
designIn a secondary data analysis of a prospective observational study, specialist palliative care doctors and nurses (in a hospice and a hospital palliative care team) provided survival predictions (yes/no/uncertain) about which patients would die within 72 hours.
resultsSurvival predictions were obtained for 49 patients. A prediction from a nurse was obtained for 37/49 patients. A prediction from a doctor was obtained for 46/49 patients. In total, 23 (47%)/49 patients actually died within 72 hours of assessment. Nurses accurately predicted the outcome in 27 (73%)/37 cases. Doctors accurately predicted the outcome in 30 (65%)/46 cases. When comparing predictions given on the same patients (27 [55%]/49), nurses were slightly better at recognising imminent death than doctors (positive predictive value (the proportion of patients who died when the clinician predicted death)=79% vs 60%, respectively). The difference in c-statistics (nurses 0.82 vs doctors 0.63) was not significant (p=0.13).
conclusionEven when patients are in the terminal phase and close to death, clinicians are not very good at predicting how much longer they will survive. Further research is warranted to improve prognostication in this population.
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