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Comparison of the accuracy of clinicians’ prediction of survival and Palliative Prognostic Score: an East Asian cross-cultural study

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Abstract

Purpose

No study has been conducted to compare the clinicians’ prediction of survival (CPS) with Palliative Prognostic Scores (PaP) across countries. We aimed to compare the performance of the CPS in PaP (PaP-CPS), the PaP without the CPS, and the PaP total scores in patients with advanced cancer in three East Asian countries.

Methods

We compared the discriminative accuracy of the three predictive models (the PaP-CPS [the score of the categorical CPS of PaP], the PaP without the CPS [sum of the scores of only the objective variables of PaP], and the PaP total score) in patients admitted to palliative care units (PCUs) in Japan, Korea, and Taiwan. We calculated the area under the receiver operating characteristic curve (AUROC) for 30-day survival to compare the discriminative accuracy of these three models.

Results

We analyzed 2,072 patients from three countries. The AUROC for the PaP total scores was 0.84 in patients in Japan, 0.76 in Korea, and 0.79 in Taiwan. The AUROC of the PaP-CPS was 0.82 in patients in Japan, 0.75 in Korea, and 0.78 in Taiwan. The AUROC of the PaP without the CPS was 0.75 in patients in Japan, 0.66 in Korea, and 0.67 in Taiwan.

Conclusion

The PaP total scores and the PaP-CPS consistently showed similar discriminative accuracy in predicting 30-day survival in patients admitted to PCUs in Japan, Korea, and Taiwan. It may be sufficient for experienced clinicians to use the CPS alone for estimating the short-term survival (less than one month) of patients with far-advanced cancer. The PaP may help to improve prognostic confidence and further reduce subjective variations.

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Data availability

The data that support the findings of this study are available from the corresponding author, Sang-Yeon Suh, upon reasonable request. All authors agree to provide data to the journal for review if needed.

Code availability

Not applicable.

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Acknowledgements

We are grateful to Harrisco Encorrection (Seoul, South Korea) for proofreading this manuscript for grammar and clarity.

Funding

This work was supported in part by a Grant-in-Aid from the Japanese Hospice Palliative Care Foundation; Grant Numbers 16H05212 and 16KT0007.

Author information

Author notes

  1. Yusuke Hiratsuka and Seok-Joon Yoon contributed equally to this work

Authors and Affiliations

  1. Department of Palliative Medicine, Takeda General Hospital, Aizu Wakamatsu, Japan

    Yusuke Hiratsuka

  2. Department of Palliative Medicine, Tohoku University School of Medicine, Sendai, Japan

    Yusuke Hiratsuka & Akira Inoue

  3. Department of Family Medicine, Chungnam National University Hospital, Daejeon, South Korea

    Seok-Joon Yoon

  4. Department of Family Medicine, Dongguk University Ilsan Hospital, Goyang, Gyeonggi-do, South Korea

    Sang-Yeon Suh

  5. Department of Medicine, Dongguk University Medical School, Pildong 1-30, Jung-gu, Seoul, South Korea

    Sang-Yeon Suh

  6. Department of Statistics, Dongguk University, Seoul, South Korea

    Sung-Eun Choi

  7. Department of Palliative Care, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    David Hui

  8. Department of Family Medicine, School of Medicine, Catholic Kwandong University International St. Mary’s Hospital, Incheon, South Korea

    Sun-Hyun Kim

  9. Department of Family Medicine, Ilsan-Paik Hospital, College of Medicine, Inje University, Goyang, South Korea

    Eon Sook Lee

  10. Department of Family Medicine, Eunpyeong St. Mary’s Hospital, The Catholic University of Korea, Seoul, South Korea

    Sun Wook Hwang

  11. Department of Family Medicine, College of Medicine and Hospital, National Taiwan University, Taipei, Taiwan

    Shao-Yi Cheng

  12. Department of Family Medicine, Kaohsiung Medical University Hospital, and School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan

    Ping-Jen Chen

  13. Division of Psychiatry, Marie Curie Palliative Care Research Department, University College London, London, UK

    Ping-Jen Chen

  14. Division of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Japan

    Masanori Mori & Tatsuya Morita

  15. Division of Palliative Care, Konan Medical Center, Kobe, Japan

    Takashi Yamaguchi

  16. Department of Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan

    Satoru Tsuneto

Authors
  1. Yusuke Hiratsuka
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  2. Seok-Joon Yoon
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  3. Sang-Yeon Suh
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  4. Sung-Eun Choi
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  5. David Hui
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  6. Sun-Hyun Kim
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  7. Eon Sook Lee
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  8. Sun Wook Hwang
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  11. Masanori Mori
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  12. Takashi Yamaguchi
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  13. Tatsuya Morita
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  14. Satoru Tsuneto
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  15. Akira Inoue
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Contributions

Yusuke Hiratsuka: Conceptualization, data curation, investigation, methodology, project administration, writing—original draft, writing—review and editing

Seok-Joon Yoon: Conceptualization, formal analysis, investigation, methodology, project administration, writing—original draft, writing—review and editing

Sang-Yeon Suh: Conceptualization, investigation, methodology, project implementation, supervision, writing—review and editing

Sung Eun Choi: Formal analysis, writing—review and editing

David Hui: Supervision, writing—review and editing

Sun-Hyun Kim: Investigation, writing—review and editing

Eon Sook Lee: Investigation, writing—review and editing

Sun Wook Hwang: Investigation, writing—review and editing

Shao-Yi Cheng: Investigation, writing—review and editing

Ping-Jen Chen: Investigation, writing—review and editing

Masanori Mori: Conceptualization, investigation, methodology, project administration, resources, supervision, writing—review and editing

Takashi Yamaguchi: Investigation, writing—review and editing

Tatsuya Morita: Funding acquisition, investigation, writing—review and editing

Satoru Tsuneto: Supervision, writing—review and editing

Akira Inoue: Investigation, supervision, writing—review and editing

Corresponding author

Correspondence to Sang-Yeon Suh.

Ethics declarations

Ethics approval

This study obtained was approved by the local Institutional Review Boards of all participating institutions. The independent ethics committee of Tohoku University School of Medicine (approval no. 2016-1-689) approved this study.

Consent to participate

In accordance with the ethical guidelines for human research of the Ministry of Health, Labor, and Welfare in Japan, patients’ informed consent was waived in Japan because of the completely observational nature of the study. Patients were provided the opportunity to opt out. In South Korea and Taiwan, informed consent was obtained from the patients or their families (in case the patient lacked the capacity to decide).

Consent for publication

The authors affirm that human research participants provided informed consent for publication of the article.

Conflict of interest

The authors declare no competing interests.

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Hiratsuka, Y., Yoon, SJ., Suh, SY. et al. Comparison of the accuracy of clinicians’ prediction of survival and Palliative Prognostic Score: an East Asian cross-cultural study. Support Care Cancer 30, 2367–2374 (2022). https://doi.org/10.1007/s00520-021-06673-0

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  • DOI: https://doi.org/10.1007/s00520-021-06673-0

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