Content Validation of Advanced Illness Criteria of a Palliative Care Screening Tool

DiLello, Lauren; Mulvihill, Karen; Carpini, Jennifer Delli; Shah, Riddhi; Hermanowski, J.; Chaubey, Damanjeet

doi:10.1089/jpm.2017.0703

Cited by 10 publications

(13 citation statements)

References 19 publications

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“…Three thousand, two hundred forty-one papers were initially retrieved from the MEDLINE search, and 77 full text articles were examined; 11 papers were added from hand search. From the 88 paper examined in full text, 16 papers [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33], were chosen because they used tools to identify criteria for PC referral. The tools were quite heterogeneous both in length (from 7 to 58 items) and in the criteria adopted.…”

Section: Phase 1: Literature Review Of Pc Referral Criteriamentioning

confidence: 99%

Development of the palliative care referral system: proposal of a tool for the referral of cancer patients to specialized palliative care

et al. 2022

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Background Early palliative care (PC) has shown beneficial effects for advanced cancer patients. However, it is still debated what criteria to use to identify patients for PC referral. Aim To document the initial steps of the development of the Palliative Care Referral System (PCRS), a tool to be used by oncologists in clinical practice. Methods A multiprofessional working group developed the PCRS based on the results of a scoping literature review on PC referral criteria. PCRS criteria were evaluated by experts via a nominal group technique (NGT). Descriptive statistics were used to summarize expert scores on relevance, appropriateness and perceived feasibility of the criteria proposed. Quotations of participants during the discussion were also reported. Results Sixteen studies, including PC referral criteria/tools, emerged from the scoping review. Severe symptoms, poor performance status, comorbidities and prognosis were the most commonly used criteria. The PCRS included nine major criteria and nine assessment methods; a scoring procedure was also proposed. Answers to the questionnaire during the NGT showed that five criteria reached full agreement on all items, while four did not, and were then discussed within the group. Participants agreed on the relevance of all criteria and on the appropriateness of methods proposed to assess most of them, while issues were raised about potential feasibility of the overall assessment of the PCRS in clinical practice. Conclusion The PCRS has been developed as an help for oncologists to timely identify patients for specialized PC referral. Since feasibility emerged as the main concern, implementation strategies have to be tested in subsequent studies.

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Section: Phase 1: Literature Review Of Pc Referral Criteriamentioning

confidence: 99%

Development of the palliative care referral system: proposal of a tool for the referral of cancer patients to specialized palliative care

et al. 2022

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Section: Introductionmentioning

confidence: 99%

“…A palliative care screening tool (PCST) is an assessment method that assists clinicians in the early identification of patients nearing EOL and in need of palliative care [7,8]. PCST collects patients' clinical data (e.g., comorbidities and functional status) and uses a scoring algorithm to estimate their length period of survival [8]. Our previous report before the COVID-19 pandemic showed that a PCST score ≥ 4 was associated with a higher chance of mortality, that is, within three months, among hospitalized patients, and could be used as a trigger to launch an ACP discussion with patients to determine their goals and AD regarding EOL treatment [9].…”

Section: Introductionmentioning

confidence: 99%

Utilization of Palliative Care Screening Tool to Early Identify Patients with COVID-19 Needing Palliative Care: A Cohort Study

Yen

Chou

et al. 2022

IJERPH

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There are very few programs that identify patients with coronavirus disease 2019 (COVID-19) who need palliative care. This cohort study presents a model to use a validated palliative care screening tool (PCST) to systematically identify hospitalized patients with COVID-19 in need of palliative care. In this prospective study, we consecutively recruited patients with COVID-19 admitted to Taipei City Hospital between 1 January and 30 July 2021. Patients’ palliative care needs were determined by using the PCST. Advance care planning (ACP) and advance directives (AD) were systemically provided for all patients with a PCST score ≥ 4. Of 897 patients, 6.1% had a PCST score ≥ 4. During the follow-up period, 106 patients died: 75 (8.9%) with a PCST score < 4 and 31 (56.4%) with a PCST score ≥ 4. The incidence of mortality was 2.08 and 0.58/100 person-days in patients with PCST scores ≥ 4 and <4, respectively. After controlling for other covariates, a PCST score ≥ 4 was associated with a higher risk of mortality in patients with COVID-19 (adjusted HR = 2.08; 95% CI: 1.22–3.54; p < 0.001). During hospitalization, 55 patients completed an ACP discussion with their physicians, which led to 15 of them completing the AD. Since hospitalized patients with COVID-19 had a high mortality rate, it is imperative to implement a comprehensive palliative care program to early identify patients needing palliative care and promotion of AD and ACP.

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“…The PCST is another assessment method assisting healthcare workers in the early identification of patients nearing EOL and in need of PC 7 , 8 , 10 . PCST collects patients’ clinical data (e.g.…”

Section: Introductionmentioning

confidence: 99%

“…PCST collects patients’ clinical data (e.g. comorbidities) and uses a scoring algorithm to estimate their period of survival 8 , 10 . Although intuitive assessment of PC and PCST are the assessment tools assisting healthcare providers in identifying patients appropriate for PC, the comparison of their prognostic accuracies remains unexplored.…”

Section: Introductionmentioning

confidence: 99%

Comparison of intuitive assessment and palliative care screening tool in the early identification of patients needing palliative care

Yen

Lai

et al. 2022

Sci Rep

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The intuitive assessment of palliative care (PC) needs and Palliative Care Screening Tool (PCST) are the assessment tools used in the early detection of patients requiring PC. However, the comparison of their prognostic accuracies has not been extensively studied. This cohort study aimed to compare the validity of intuitive assessment and PCST in terms of recognizing patients nearing end-of-life (EOL) and those appropriate for PC. All adult patients admitted to Taipei City Hospital from 2016 through 2019 were included in this prospective study. We used both the intuitive assessment of PC and PCST to predict patients’ 6-month mortality and identified those appropriate for PC. The c-statistic value was calculated to indicate the predictive accuracies of the intuition and PCST. Of 111,483 patients, 4.5% needed PC by the healthcare workers’ intuitive assessment, and 6.7% had a PCST score ≥ 4. After controlling for other covariates, a positive response ‘yes’ to intuitive assessment of PC needs [adjusted odds ratio (AOR) = 9.89; 95% confidence interval (CI) 914–10.71] and a PCST score ≥ 4 (AOR = 6.59; 95%CI 6.17–7.00) were the independent predictors of 6-month mortality. Kappa statistics showed moderate concordance between intuitive assessment and PCST in predicting patients' 6-month mortality (k = 0.49). The c-statistic values of the PCST at recognizing patients’ 6-month mortality was significantly higher than intuition (0.723 vs. 0.679; p < 0.001). As early identification of patients in need of PC could improve the quality of EOL care, our results suggest that it is imperative to screen patients’ palliative needs by using a highly accurate screening tool of PCST.

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Content Validation of Advanced Illness Criteria of a Palliative Care Screening Tool

Abstract: Cross-sectional feedback of healthcare professionals validated criteria of advanced illness in the PCST.

Cited by 10 publications

References 19 publications

Development of the palliative care referral system: proposal of a tool for the referral of cancer patients to specialized palliative care

Development of the palliative care referral system: proposal of a tool for the referral of cancer patients to specialized palliative care

Utilization of Palliative Care Screening Tool to Early Identify Patients with COVID-19 Needing Palliative Care: A Cohort Study

Comparison of intuitive assessment and palliative care screening tool in the early identification of patients needing palliative care

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