Development and Validation of the PaP Score Nomogram for Terminally Ill Cancer Patients
The validated Palliative Prognostic (PaP) score predicts survival in terminally ill cancer patients, assigning patients to three different risk groups according to a 30-day survival probability: group A, >70%; group B, 30–70%; and group C, <30%. We aimed to develop and validate a PaP nomogram...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/10/2510 |
| _version_ | 1797500985255395328 |
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| author | Emanuela Scarpi Oriana Nanni Marco Maltoni |
| author_facet | Emanuela Scarpi Oriana Nanni Marco Maltoni |
| author_sort | Emanuela Scarpi |
| collection | DOAJ |
| description | The validated Palliative Prognostic (PaP) score predicts survival in terminally ill cancer patients, assigning patients to three different risk groups according to a 30-day survival probability: group A, >70%; group B, 30–70%; and group C, <30%. We aimed to develop and validate a PaP nomogram to provide individualized prediction of survival at 15, 30 and 60 days. Three cohorts of consecutive terminally ill cancer patients were used: one (<i>n</i> = 519) for nomogram development and internal validation, and a second (<i>n</i> = 451) and third (<i>n</i> = 549) for external validation. Multivariate analyses included dyspnea, anorexia, Karnofsky performance status, clinical prediction of survival, total white blood count and lymphocyte percentage. The predictive accuracy of the nomogram was determined by Harrell’s concordance index (95% CI), and calibration plots were generated. The nomogram had a concordance index of 0.74 (0.72–0.75) and showed good calibration. The internal validation showed no departures from ideal prediction. The accuracy of the nomogram at 15, 30 and 60 days was 74% (70–77), 89% (85–92) and 72% (68–76) in the external validation cohorts, respectively. The PaP nomogram predicts the individualized estimate of survival and could greatly facilitate clinical care decision-making at the end of life. |
| first_indexed | 2024-03-10T03:11:45Z |
| format | Article |
| id | doaj.art-904975121db64ec488debf5d7e161d1b |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T03:11:45Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-904975121db64ec488debf5d7e161d1b2023-11-23T10:24:12ZengMDPI AGCancers2072-66942022-05-011410251010.3390/cancers14102510Development and Validation of the PaP Score Nomogram for Terminally Ill Cancer PatientsEmanuela Scarpi0Oriana Nanni1Marco Maltoni2Unit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, ItalyUnit of Biostatistics and Clinical Trials, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, ItalyMedical Oncology Unit, Department of Specialized, Experimental and Diagnostic Medicine (DIMES), University of Bologna, 40126 Bologna, ItalyThe validated Palliative Prognostic (PaP) score predicts survival in terminally ill cancer patients, assigning patients to three different risk groups according to a 30-day survival probability: group A, >70%; group B, 30–70%; and group C, <30%. We aimed to develop and validate a PaP nomogram to provide individualized prediction of survival at 15, 30 and 60 days. Three cohorts of consecutive terminally ill cancer patients were used: one (<i>n</i> = 519) for nomogram development and internal validation, and a second (<i>n</i> = 451) and third (<i>n</i> = 549) for external validation. Multivariate analyses included dyspnea, anorexia, Karnofsky performance status, clinical prediction of survival, total white blood count and lymphocyte percentage. The predictive accuracy of the nomogram was determined by Harrell’s concordance index (95% CI), and calibration plots were generated. The nomogram had a concordance index of 0.74 (0.72–0.75) and showed good calibration. The internal validation showed no departures from ideal prediction. The accuracy of the nomogram at 15, 30 and 60 days was 74% (70–77), 89% (85–92) and 72% (68–76) in the external validation cohorts, respectively. The PaP nomogram predicts the individualized estimate of survival and could greatly facilitate clinical care decision-making at the end of life.https://www.mdpi.com/2072-6694/14/10/2510cancer patientsend-of-lifehospicepalliative careprognosisprognostic score |
| spellingShingle | Emanuela Scarpi Oriana Nanni Marco Maltoni Development and Validation of the PaP Score Nomogram for Terminally Ill Cancer Patients Cancers cancer patients end-of-life hospice palliative care prognosis prognostic score |
| title | Development and Validation of the PaP Score Nomogram for Terminally Ill Cancer Patients |
| title_full | Development and Validation of the PaP Score Nomogram for Terminally Ill Cancer Patients |
| title_fullStr | Development and Validation of the PaP Score Nomogram for Terminally Ill Cancer Patients |
| title_full_unstemmed | Development and Validation of the PaP Score Nomogram for Terminally Ill Cancer Patients |
| title_short | Development and Validation of the PaP Score Nomogram for Terminally Ill Cancer Patients |
| title_sort | development and validation of the pap score nomogram for terminally ill cancer patients |
| topic | cancer patients end-of-life hospice palliative care prognosis prognostic score |
| url | https://www.mdpi.com/2072-6694/14/10/2510 |
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