Can survival in cancer patients be accurately predicted with the Palliative Performance Scale?
Bibliographic record
Abstract
Introduction: Palliative Performance Scale (PPS), Karnofsky Performance Scale (KPS) and the Edmonton Symptom Assessment Scale (ESAS) are widely used prognostic scales in palliative care unit. Institutionalized palliative care services in our country are quite new compared to the practices in many countries. We do not have concrete data on the compatibility of these scales, which are developed with patient data from other countries, in our own palliative care practices with real cases. In this study, we aimed to evaluate the convenience of the Turkish versions of these scales on the first days of hospitalization of terminal cancer patients who were followed up in the palliative clinic of our hospital. We also questioned whether the initial estimated survival and actual survival were compatible. Methods: PPS, KPS and ESAS on the first days of hospitalization of terminal cancer patients, hospitalized in the palliative clinic of our hospital between November 14, 2016 and November 14, 2017, were retrospectively evaluated one year later (n = 222). The survivors and those who lost their lives were determined. The survival estimates with PPS of the patients who died were compared with their actual survival.Results: The average age of 222 patients (18% female, 82% male) participating in the study was 64.49 ± 11.62, and the range was 26-91. PPS, KPS, ESAS were determined as a mean value of 34.40±18.00 (min. 10-max. 90), 32.90±17.50 (min. 10-max. 90), 56.10±15.65 (min. 2-max. 90), respectively. The AUC of PPS is 0.83 (p<0.001) and the AUC of KPS is 0.78 (p<0.001) suggesting that KPS and PPS has at least one tie between alive and dead patients, which is 45%. Median survival time was found 14.00, 95% C.I. [10.87–17.13]. Conclusion: In our study, it was found that as the KPS and PPS scores decrease, the survival time of terminal cancer patients decrease. Patients with PPS <45% had a higher risk of death (sensitivity 71%, specificity 80%), patients with KPS <45% had a higher risk of death (sensitivity 60%, specificity 81%), and patients with ESAS> 60.50 had a higher risk of death (sensitivity 93%, specificity 45%). PPS is a useful assessment scale for predicting survival of terminal cancer patients in the palliative care unit. We think it is important in determining our patient-specific palliative approach and treatments.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".