Performance of clinician prediction of survival in oncology outpatients with advanced cancer.
<h4>Background</h4>We aimed to investigate the performance of clinician prediction of survival (CPS) and the association between CPS and the prognostic confidence of clinicians in ambulatory medical oncology outpatients.<h4>Methods</h4>Eight medical oncologists estimated the...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2022-01-01
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| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0267467 |
| _version_ | 1828804602204520448 |
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| author | Yu Jung Kim Seok Joon Yoon Sang-Yeon Suh Yusuke Hiratsuka Beodeul Kang Si Won Lee Hong-Yup Ahn Koung Jin Suh Ji-Won Kim Se Hyun Kim Jin Won Kim Keun-Wook Lee Jee Hyun Kim Jong Seok Lee |
| author_facet | Yu Jung Kim Seok Joon Yoon Sang-Yeon Suh Yusuke Hiratsuka Beodeul Kang Si Won Lee Hong-Yup Ahn Koung Jin Suh Ji-Won Kim Se Hyun Kim Jin Won Kim Keun-Wook Lee Jee Hyun Kim Jong Seok Lee |
| author_sort | Yu Jung Kim |
| collection | DOAJ |
| description | <h4>Background</h4>We aimed to investigate the performance of clinician prediction of survival (CPS) and the association between CPS and the prognostic confidence of clinicians in ambulatory medical oncology outpatients.<h4>Methods</h4>Eight medical oncologists estimated the expected survival of their patients in a prospective cohort study. They were asked to provide a temporal type of CPS in weeks, together with their level of confidence for each prediction (0-100%). We analyzed the accuracy of CPS, the association between CPS and the prognostic confidence, and the characteristics of patients showing inaccurate CPS.<h4>Results</h4>A total of 200 advanced cancer patients were enrolled and the median overall survival was 7.6 months. CPS was accurate in 67 (33.5%) patients, underestimated in 87 (43.5%), and overestimated in 46 (23.0%). The overall accuracy of CPS for 12-week, 24-week, 36-week, and 48-week survival was 83.0%, 72.0%, 75.5%, and 74.0%, respectively. The specificity was highest for 12-week survival (90.2%) and the sensitivity was highest for 48-week survival (96.1%). The sensitivity of 12-week CPS was 51.4% and the area under the receiver operating characteristic (AUROC) curve was 0.79 (95% confidence interval [CI] 0.71-0.87). The prognostic confidence of clinicians was not significantly associated with the accuracy of prediction (P = 0.359). Patients with overestimated survival had significantly poorer global health status and physical/role/emotional functioning in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Additionally, they showed significantly higher levels of fatigue, nausea/vomiting, pain, dyspnea, and loss of appetite.<h4>Conclusion</h4>The overall accuracy of CPS in predicting 12-week to 48-week survival was high in medical oncology outpatients. However the sensitivity of 12-week CPS was low and prognostic confidence was not associated with the accuracy of CPS. Patients with overestimated CPS showed poorer quality of life and higher symptom burden. |
| first_indexed | 2024-12-12T07:42:56Z |
| format | Article |
| id | doaj.art-22694d3546f846109e79726b6b6ce827 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-12T07:42:56Z |
| publishDate | 2022-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-22694d3546f846109e79726b6b6ce8272022-12-22T00:32:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032022-01-01174e026746710.1371/journal.pone.0267467Performance of clinician prediction of survival in oncology outpatients with advanced cancer.Yu Jung KimSeok Joon YoonSang-Yeon SuhYusuke HiratsukaBeodeul KangSi Won LeeHong-Yup AhnKoung Jin SuhJi-Won KimSe Hyun KimJin Won KimKeun-Wook LeeJee Hyun KimJong Seok Lee<h4>Background</h4>We aimed to investigate the performance of clinician prediction of survival (CPS) and the association between CPS and the prognostic confidence of clinicians in ambulatory medical oncology outpatients.<h4>Methods</h4>Eight medical oncologists estimated the expected survival of their patients in a prospective cohort study. They were asked to provide a temporal type of CPS in weeks, together with their level of confidence for each prediction (0-100%). We analyzed the accuracy of CPS, the association between CPS and the prognostic confidence, and the characteristics of patients showing inaccurate CPS.<h4>Results</h4>A total of 200 advanced cancer patients were enrolled and the median overall survival was 7.6 months. CPS was accurate in 67 (33.5%) patients, underestimated in 87 (43.5%), and overestimated in 46 (23.0%). The overall accuracy of CPS for 12-week, 24-week, 36-week, and 48-week survival was 83.0%, 72.0%, 75.5%, and 74.0%, respectively. The specificity was highest for 12-week survival (90.2%) and the sensitivity was highest for 48-week survival (96.1%). The sensitivity of 12-week CPS was 51.4% and the area under the receiver operating characteristic (AUROC) curve was 0.79 (95% confidence interval [CI] 0.71-0.87). The prognostic confidence of clinicians was not significantly associated with the accuracy of prediction (P = 0.359). Patients with overestimated survival had significantly poorer global health status and physical/role/emotional functioning in the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30). Additionally, they showed significantly higher levels of fatigue, nausea/vomiting, pain, dyspnea, and loss of appetite.<h4>Conclusion</h4>The overall accuracy of CPS in predicting 12-week to 48-week survival was high in medical oncology outpatients. However the sensitivity of 12-week CPS was low and prognostic confidence was not associated with the accuracy of CPS. Patients with overestimated CPS showed poorer quality of life and higher symptom burden.https://doi.org/10.1371/journal.pone.0267467 |
| spellingShingle | Yu Jung Kim Seok Joon Yoon Sang-Yeon Suh Yusuke Hiratsuka Beodeul Kang Si Won Lee Hong-Yup Ahn Koung Jin Suh Ji-Won Kim Se Hyun Kim Jin Won Kim Keun-Wook Lee Jee Hyun Kim Jong Seok Lee Performance of clinician prediction of survival in oncology outpatients with advanced cancer. PLoS ONE |
| title | Performance of clinician prediction of survival in oncology outpatients with advanced cancer. |
| title_full | Performance of clinician prediction of survival in oncology outpatients with advanced cancer. |
| title_fullStr | Performance of clinician prediction of survival in oncology outpatients with advanced cancer. |
| title_full_unstemmed | Performance of clinician prediction of survival in oncology outpatients with advanced cancer. |
| title_short | Performance of clinician prediction of survival in oncology outpatients with advanced cancer. |
| title_sort | performance of clinician prediction of survival in oncology outpatients with advanced cancer |
| url | https://doi.org/10.1371/journal.pone.0267467 |
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