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Prognostication in palliative care

Chu, C; White, N; Stone, P; (2019) Prognostication in palliative care. Clinical Medicine , 19 (4) pp. 306-310. 10.7861/clinmedicine.19-4-306. Green open access

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Abstract

An accurate prognosis about how long a terminally ill patient has left to live, when disclosed sensitively in open discussions, can facilitate patient-centred care and shared decision making. In addition, several guidelines, policies and funding streams rely, to some extent, on a clinician estimated prognosis. However, clinician predictions alone have been shown to be unreliable and over-optimistic. The factors underlying clinicians’ prognostic decisions (particularly at the very end of life) are beginning to be elucidated. As an alternative to clinicians’ subjective estimates, a number of prognostic algorithms and scores have been developed and validated, but only a few have consistently shown superiority to clinician predictions. Therefore, an element of uncertainty remains and this needs to be acknowledged when having conversations with patients and their families. Guidelines are available to advise clinicians about how to prepare for, participate in and record prognostic conversations.

Type: Article
Title: Prognostication in palliative care
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.7861/clinmedicine.19-4-306
Publisher version: https://doi.org/10.7861/clinmedicine.19-4-306
Language: English
Additional information: This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Palliative care, terminal care, prognosis, communication, algorithm
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10078773
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