SynthesisBMJ supportive & palliative care2024
The Surprise Question and clinician-predicted prognosis: systematic review and meta-analysis.
Synthesis in BMJ supportive & palliative care, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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.
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.
Who cites it
16 citing papers in PubMed.
- Palliative Care in Patients with Liver Cirrhosis: A Scoping Review of Identification, Interventions, and Implementation Barriers and Facilitators.Healthcare (Basel, Switzerland) · 2026Review
- Elective admissions and treatments in the final three months of life: a nationwide retrospective study of older adults.European geriatric medicine · 2026Article
- Trigger Criteria for Advance Care Planning in Adults With Congenital Heart Disease: A Systematic Review.CJC pediatric and congenital heart disease · 2026Review
- Health care crisis: looking beyond the obvious: Part 3: Roadmap for an equitable and sustainable health care system.Canadian family physician Medecin de famille canadien · 2026Article
- Signs and symptoms indicating the transition to the palliative phase in patients with COPD and heart failure in primary healthcare: a mixed-methods study.BMC palliative care · 2026Article
- Navigating Postacute Care Options for Patients After Hospital Discharge: A Review.JAMA internal medicine · 2026Review
- Factors associated with a positive response to the surprise question in complex chronic patients treated by advanced practice nurses in primary care.BMC palliative care · 2026Article
- "Do Everything" versus realistic surgical interventions: navigating the road to shared decision-making in trauma surgery.Trauma surgery & acute care open · 2026Review
- Decision tree model to predict one-year survival in ambulatory patients with advanced cancer.PloS one · 2026Article
- The surprise question: predictive accuracy in an unselected emergency department population - a prospective study in nurses and physicians.Annals of medicine · 2025Article
- Promising Concept, Challenging Implementation of a Minimally Invasive Intervention (MINI) to Identify Patients in Their Last Year of Life-A Multi-Methods Feasibility Study at a German University Hospital.Healthcare (Basel, Switzerland) · 2025Article
- When Good Intentions Meet Predictive Uncertainty: Prognostication in the Intensive Care Unit.Annals of the American Thoracic Society · 2025Article
- 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
- Article
- The Surprise Question: Not Ready for Prime Time.Palliative medicine reports · 2024Article
- Needs Assessment of Patients Requiring End-of-Life Care: A Community-based Cross-sectional Study.Indian journal of palliative careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe Surprise Question, 'Would you be surprised if this person died within the next year?' is a simple tool that can be used by clinicians to identify people within the last year of life. This review aimed to determine the accuracy of this assessment, across different healthcare settings, specialties, follow-up periods and respondents.
methodsSearches were conducted of Medline, Embase, AMED, PubMed and the Cochrane Central Register of Controlled Trials, from inception until 01 January 2024. Studies were included if they reported original data on the ability of the Surprise Question to predict survival. For each study (including subgroups), sensitivity, specificity, positive and negative predictive values and accuracy were determined.
resultsOur dataset comprised 56 distinct cohorts, including 68 829 patients. In a pooled analysis, the sensitivity of the Surprise Question was 0.69 ((0.64 to 0.74) I
conclusionsThe Surprise Question demonstrated modest accuracy with considerable heterogeneity across the population to which it was applied and to whom it was posed. Prospective studies should test whether the prompt can facilitate timely access to palliative care services, as originally envisioned. PROSPERO REGISTRATION NUMBER: CRD32022298236.
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Registered trials
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.