| Title: |
How accurate is clinical prognostication by oncologists during routine practice in a general hospital and can it be improved by a specific prognosis training programme: a prospective interventional study |
| Authors: |
Jan Braess, Alexander Crispin, Irma Kupf, Gabriele Thanner, Michael Gerken |
| Source: |
BMJ Open, Vol 14, Iss 6 (2024) |
| Publisher Information: |
BMJ Publishing Group, 2024. |
| Publication Year: |
2024 |
| Collection: |
LCC:Medicine |
| Subject Terms: |
Medicine |
| More Details: |
Objectives Oncologists need competence in clinical prognostication to deliver appropriate care to patients with cancer. Most studies on prognostication have been restricted to patients in palliative care settings. This paper investigates (1) the prognostic accuracy of physicians regarding a broad cohort of patients with cancer with a median life expectancy of >2 years and (2) whether a prognosis training can improve prognostication.Design Prospective single-centre study comprising 3 phases, each lasting 1 month.Setting Large teaching hospital, department of oncology and haematology, Germany.Participants 18 physicians with a professional experience from entry level to 34 years. 736 patients with oncological and malignant haematological diseases.Interventions Baseline prognostication abilities were recorded during an ‘untrained’ phase 1. As an intervention, a specific prognosis-training programme was implemented prior to phases 2 and 3. In phase 3, physicians had to provide additional estimates with the inclusion of electronic prognostic tools.Outcome measures Prognostic estimates (PE) were collected using ‘standard’ surprise question (SQ), ‘probabilistic’ SQ (both for short-term prognostication up to 6 months) and clinician prediction of survival (CPS) (for long-term prognostication). Estimated prognoses were compared with observed survival. Phase 1 was compared with phases 2 and 3.Results We included 2427 PE for SQ, 1506 for CPS and 800 for probabilistic SQ. Median OS was 2.5 years. SQ accuracy improved significantly (p |
| Document Type: |
article |
| File Description: |
electronic resource |
| Language: |
English |
| ISSN: |
2044-6055 |
| Relation: |
https://bmjopen.bmj.com/content/14/6/e081661.full; https://doaj.org/toc/2044-6055 |
| DOI: |
10.1136/bmjopen-2023-081661 |
| Access URL: |
https://doaj.org/article/515ba3e389ac4c84ade76e7bb914bbea |
| Accession Number: |
edsdoj.515ba3e389ac4c84ade76e7bb914bbea |
| Database: |
Directory of Open Access Journals |
