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Scoring System May Tell the Dying How Long They Have to Live
Date:8/26/2011

than any one doctor's estimate at predicting survival. Neither score is more reliable than a prediction that combines more than one medical opinion. The findings were reported in the Aug. 25 online edition of the BMJ.

There are some caveats, said Dr. Paul Glare, chief of the department of pain and palliative care at Memorial Sloan-Kettering Cancer Center in New York City, including the fact that an electronic "app" is needed to use the new scoring system.

"They are developing an app, but we want simple tools that clinicians can use without a computer," he said. Another limitation is that the PiPS-B measures blood levels of C-reactive protein (CRP); in the United States, doctors do not routinely measure blood levels of this inflammation marker among people with advanced cancer.

Still, a tool would be helpful, Glare said. "Clinicians may give an optimistic spin so patients think they have much longer to live than they really do," he said. "Doctors normally overestimate this information by a factor of four or five," he noted. "We don't want to take away hope, but we should be at least as accurate as possible so people can plan."

How such information is communicated to patients and their loved ones also matters, Glare said.

There are always scenarios where people exceed expectations, he added, and understanding more about these outliers may help any future tools become more accurate.

More information

To learn more about palliative care, visit the National Palliative Care Research Center.

SOURCES: Patrick C. Stone, M.D., St. George's University of London; Paul Glare, M.D., chief, department of pain and palliative care, Memorial Sloan-Kettering Cancer Center, New York City; Porter Storey, MD, executive vice president of the American Academy of Hospice and Palliative Medicine; Aug. 25, 2011, BMJ, online


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