Is a Combination of Six Clinical Tests Useful as a Measure to Predict Short-Term Prognosis in Terminal Cancer Patients? A Prospective Observational Study in a Japanese Palliative Care Unit

Background: To address the need for short-term prognostic methods using objective measures, we developed a method to predict a 2- or 3-week prognosis using only six clinical tests (known as the WPCBAL score). However, the method has not yet been directly compared with globally accepted prognostic me...

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Main Authors: Kazuyuki Niki, Yoshiaki Okamoto, Maki Yasui, Takahito Omae, Makie Kohno, Yoshinobu Matsuda
Format: Article
Language:English
Published: Mary Ann Liebert 2024-10-01
Series:Palliative Medicine Reports
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Online Access:https://www.liebertpub.com/doi/10.1089/pmr.2024.0026
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author Kazuyuki Niki
Yoshiaki Okamoto
Maki Yasui
Takahito Omae
Makie Kohno
Yoshinobu Matsuda
author_facet Kazuyuki Niki
Yoshiaki Okamoto
Maki Yasui
Takahito Omae
Makie Kohno
Yoshinobu Matsuda
author_sort Kazuyuki Niki
collection DOAJ
description Background: To address the need for short-term prognostic methods using objective measures, we developed a method to predict a 2- or 3-week prognosis using only six clinical tests (known as the WPCBAL score). However, the method has not yet been directly compared with globally accepted prognostic methods. Objectives: This study aimed to clarify the usefulness of the WPCBAL score by comparing it with other prediction methods. Setting/Subjects: A prospective observational study was conducted with patients admitted to the palliative care unit of a Municipal Hospital in Japan between November 2017 and May 2021. Measurements: The primary endpoint was each prediction method’s accuracy—the WPCBAL score, Glasgow Prognostic Score (GPS), Palliative Prognostic Index (PPI), Palliative Prognostic Score (PaP), Delirium-Palliative Prognostic Score (D-PaP), and Prognosis in Palliative Care Study predictor models (PiPS-A, PiPS-B)—in predicting a prognosis at 2 or 3 weeks. The secondary endpoints were sensitivity, specificity, positive and negative predictive values, area under the receiver operating characteristic curve, and each prediction method’s feasibility rate. Results: In total, 181 patients were included in this study. For the 3-week prognosis, the PaP had the highest accuracy (0.746), followed by the D-PaP (0.735), WPCBAL (0.696), PPI (0.652), and GPS (0.575). For the 2-week prognosis, the PiPS-B had the highest accuracy (0.702), followed by the WPCBAL (0.696) and PiPS-A (0.641). Conclusions: The WPCBAL score’s accuracy in predicting a 2- or 3-week prognosis was comparable to that of commonly used prognostic methods, thus suggesting its usefulness as a short-term prognostic method.
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spelling doaj-art-a6222ac93759433e99cd0bb4c6b1d30a2025-08-20T01:49:57ZengMary Ann LiebertPalliative Medicine Reports2689-28202024-10-015143043710.1089/pmr.2024.0026Is a Combination of Six Clinical Tests Useful as a Measure to Predict Short-Term Prognosis in Terminal Cancer Patients? A Prospective Observational Study in a Japanese Palliative Care UnitKazuyuki Niki0Yoshiaki Okamoto1Maki Yasui2Takahito Omae3Makie Kohno4Yoshinobu Matsuda5Department of Clinical Pharmacy Research and Education, Osaka University Graduate School of Pharmaceutical Sciences, Osaka, Japan.Department of Pharmacy, Ashiya Municipal Hospital, Hyogo, Japan.Department of Clinical Pharmacy Research and Education, Osaka University Graduate School of Pharmaceutical Sciences, Osaka, Japan.Omae Homecare Clinic, Amagasaki, Japan.Department of Palliative Care, Ashiya Municipal Hospital, Hyogo, Japan.Department of Palliative Care, Ashiya Municipal Hospital, Hyogo, Japan.Background: To address the need for short-term prognostic methods using objective measures, we developed a method to predict a 2- or 3-week prognosis using only six clinical tests (known as the WPCBAL score). However, the method has not yet been directly compared with globally accepted prognostic methods. Objectives: This study aimed to clarify the usefulness of the WPCBAL score by comparing it with other prediction methods. Setting/Subjects: A prospective observational study was conducted with patients admitted to the palliative care unit of a Municipal Hospital in Japan between November 2017 and May 2021. Measurements: The primary endpoint was each prediction method’s accuracy—the WPCBAL score, Glasgow Prognostic Score (GPS), Palliative Prognostic Index (PPI), Palliative Prognostic Score (PaP), Delirium-Palliative Prognostic Score (D-PaP), and Prognosis in Palliative Care Study predictor models (PiPS-A, PiPS-B)—in predicting a prognosis at 2 or 3 weeks. The secondary endpoints were sensitivity, specificity, positive and negative predictive values, area under the receiver operating characteristic curve, and each prediction method’s feasibility rate. Results: In total, 181 patients were included in this study. For the 3-week prognosis, the PaP had the highest accuracy (0.746), followed by the D-PaP (0.735), WPCBAL (0.696), PPI (0.652), and GPS (0.575). For the 2-week prognosis, the PiPS-B had the highest accuracy (0.702), followed by the WPCBAL (0.696) and PiPS-A (0.641). Conclusions: The WPCBAL score’s accuracy in predicting a 2- or 3-week prognosis was comparable to that of commonly used prognostic methods, thus suggesting its usefulness as a short-term prognostic method.https://www.liebertpub.com/doi/10.1089/pmr.2024.0026laboratory test valueobjective prognostic predictionpalliative care unitpatient with terminal cancer
spellingShingle Kazuyuki Niki
Yoshiaki Okamoto
Maki Yasui
Takahito Omae
Makie Kohno
Yoshinobu Matsuda
Is a Combination of Six Clinical Tests Useful as a Measure to Predict Short-Term Prognosis in Terminal Cancer Patients? A Prospective Observational Study in a Japanese Palliative Care Unit
Palliative Medicine Reports
laboratory test value
objective prognostic prediction
palliative care unit
patient with terminal cancer
title Is a Combination of Six Clinical Tests Useful as a Measure to Predict Short-Term Prognosis in Terminal Cancer Patients? A Prospective Observational Study in a Japanese Palliative Care Unit
title_full Is a Combination of Six Clinical Tests Useful as a Measure to Predict Short-Term Prognosis in Terminal Cancer Patients? A Prospective Observational Study in a Japanese Palliative Care Unit
title_fullStr Is a Combination of Six Clinical Tests Useful as a Measure to Predict Short-Term Prognosis in Terminal Cancer Patients? A Prospective Observational Study in a Japanese Palliative Care Unit
title_full_unstemmed Is a Combination of Six Clinical Tests Useful as a Measure to Predict Short-Term Prognosis in Terminal Cancer Patients? A Prospective Observational Study in a Japanese Palliative Care Unit
title_short Is a Combination of Six Clinical Tests Useful as a Measure to Predict Short-Term Prognosis in Terminal Cancer Patients? A Prospective Observational Study in a Japanese Palliative Care Unit
title_sort is a combination of six clinical tests useful as a measure to predict short term prognosis in terminal cancer patients a prospective observational study in a japanese palliative care unit
topic laboratory test value
objective prognostic prediction
palliative care unit
patient with terminal cancer
url https://www.liebertpub.com/doi/10.1089/pmr.2024.0026
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