Wednesday, May 30, 2007
Here is a listing of many online resources for prognostication near the end-of-life. This post is made after a request from a audience member at a talk I gave recently on Evidence-Based Prognostication. My plan is to update these links and qualify them over the next several weeks. Please feel free to add more in the comments section or email them to me.
Last Update July 9th, 2008
Updates are in bold italics
- Advanced Cancer B12-CRP Index via Pallimed
- Breast Adjuvant! Online
- Lung Adjuvant! Online
- Colon Adjuvant! Online
- Paraneoplastic/Complications via EPERC Fast Facts
Congestive Heart Failure
- Seattle Heart Failure Model via University of Washington
- EFFECT (Enhanced Feedback for Effective Cardiac Treatment) via CCORT
- MELD Score (Model for End Stage Liver Disease) via Mayo Clinic
- Primary Biliary Cirrhosis via Mayo Clinic
Hospice/Palliative Care Patients
- Palliative Performance Scale v2 (Victoria Hospice) in conjunction with the tables found in these two articles:
- Harrold J, Rickerson E, Carroll JT, et al. Is the palliative performance scale a useful predictor of mortality in a heterogeneous hospice population? J Palliat Med. Jun 2005;8(3):503-509.
- Lau F, Downing GM, Lesperance M, Shaw J, Kuziemsky C. Use of Palliative Performance Scale in end-of-life prognostication. J Palliat Med. Oct 2006;9(5):1066-1075.
Victoria Hospice has a number of great prognostic tools on their website as part of the Victoria Palliative Research Network.
- Or you can use the Victoria Hospice Prognostat, based on their collective knowledge of PPS scores and survival over the last 10+ years.
Palliative Prognostic (PaP) Score requires evaluation of dyspnea, anorexia, KPS, clinical estimate of survival, total WBC, and lymphocyte percentage. Groups into 3 categories of chance at 30d survival. (Via EPERC Fast Facts)
Palliative Prognostic Index requires PPS, estimate of oral intake, and evaluation of edema, dyspnea, and delirium. See page 4 of this PDF for the scale.
Best Book About Medical Prognostication
There may be other prognostic models out there, but I selected the above based on the following criteria:
- Clinically relevant
- Accessible online
- Ease of use
- Validated/Studied Populations
- Outcome Relevancy
- Ease of Use
- Unique Factors
- Key Articles Supporting Score/Index