Evidence map›Paper›PMID 39966759›Full record

ArticleBMC palliative care2025

Dementia as a predictor of palliative care: Uncovering patient patterns based on German claims data.

Elena Rakuša, Constantin Reinke, Gabriele Doblhammer, Lukas Radbruch, Matthias Schmid, Thomas Welchowski

Erratum issuedAbstract read
In one paragraph

Article in BMC palliative care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Elena RakušaGerman Center for Neurodegenerative Diseases, 53127, Bonn, Germany. elena.rakusa@dzne.de.
Constantin ReinkeInstitute for Sociology and Demography, Faculty of Economics and Social Sciences, University Rostock, Ulmenstraße 69, 18057, Rostock, Germany.
Gabriele DoblhammerGerman Center for Neurodegenerative Diseases, 53127, Bonn, Germany.
Lukas RadbruchDepartment of Palliative Medicine, University Hospital Bonn, 53127, Bonn, Germany.
Matthias SchmidGerman Center for Neurodegenerative Diseases, 53127, Bonn, Germany.
Thomas WelchowskiInstitute of Medical Biometry, Informatics and Epidemiology (IMBIE), Medical Faculty, University of Bonn, 53127, Bonn, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPalliative care aims to ensure a dignified and self-determined life for people facing the end of life. While palliative care is established for tumor diseases, it's notably absent from German medical guidelines for other progressive diseases with an unfavorable prognosis such as dementia. This study will identify predictors of palliative care use in older patients and explore how these predictors relate to the probability of palliative care.

methodsWe used data from the largest German health insurance company of people over 50 years of age from the period 2014-2019. The analysis focused on the last year of life. Outcomes were outpatient and inpatient palliative care and predictors were demographics, comorbidities, therapeutic remedies and rehabilitation, care and medical interventions, medication and patient group. Combined logistic regression models and discrete conditional inference survival forests were used to predict the utilization of outpatient and inpatient palliative care. For evaluation we used concordance-index and calibration plots. We identified the most important predictors by using a permutation approach and the log-loss metric.

resultsThe study cohort for the analysis of inpatient palliative care comprised 43,896 patients, while the cohort for the analysis of outpatient palliative care included a total of 37,430 patients. The models had appropriate discriminatory power (inpatient palliative care: concordance-index = 0.737 (95%CI = 0.721-0.754); outpatient palliative care: concordance-index = 0.689; 95%CI = 0.675-0.704) and showed appropriate calibration. A diagnosis of dementia, like a diagnosis of cancer, is predictive of inpatient palliative care and outpatient palliative care. We observed a lower probability for inpatient and for outpatient palliative care for dementia patients compared to cancer patients.

conclusionsThe findings highlight the need to focus palliative care on other patient groups besides cancer patients, such as dementia patients, and to facilitate access for all patients.

Indexed as

DementiaPalliative CareAgedAged, 80 and overCohort StudiesFemaleGermanyHumansLogistic ModelsMaleMiddle AgedDementiaEnd-of-lifeMachine learningPalliative carePredictions

Identifiers

PMID39966759
PMCPMC11834269

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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.