Prognosticating in Palliative Care: A survey of Canadian Palliative Care Physicians

Abstract

Objective: To determine how palliative care physicians view the accuracy and importance of prognostication, what information they consider, and what processes they use. Methods: A questionnaire was sent to members of the Canadian Society of Palliative Care Physicians (CSPCP). Respondents recorded their perceptions about prognostication and the factors they considered when predicting survival. A patient scenario was described in which a prognosis was requested by two different people: a patient's daughter and a palliative care admissions coordinator. Results: 90 responses were received from 219 CSPCP members (41.1 percent). There was moderate agreement be tween respondents’ perceptions of their own accuracy and that of other physicians (κ=0.549). Of all the respondents, 89.9 percent believed that prognosticating was somewhat or very important. They considered clinical factors most commonly when prognosticating. A range of predictions was given for the scenario; often, the same physician gave different answers to the two people requesting a prognosis. Conclusion: Palliative care physicians believe that prognostication is important and use clinical factors to estimate survival. They often give different estimates to different information recipients.