Validation of a concise screening tool for the identification of palliative care needs among inpatients: A prospective study in hospital setting

J Formos Med Assoc. 2019 May;118(5):883-890. doi: 10.1016/j.jfma.2018.10.004. Epub 2018 Nov 28.

Abstract

Background/purpose: Very few studies have investigated the screening tools that aim to identify the need of palliative care services among patients with advanced cancer or chronic non-malignant diseases. This study validated the one-page Taiwanese version-Palliative Care Screening Tool (TW-PCST) for screening inpatients with potential palliative care needs.

Method: ROC curves were produced to examine the sensitivities and specificities at varying cut-off points. The optimal cut-off value to predict mortality was justified using the Youden's index. The screening was conducted on the first day of admission. Patients were prospectively followed-up after the baseline assessment. Three followed-up periods, namely 14 days, 90 days, and 180 days were analyzed.

Results: A total of 21,596 patients were screened. AUCs for all cut-off scores varied from 0.84 to 0.88. A total-ABCD score ≥2 gave the highest Youden's index for 90 days and 180 days follow-up periods. The optimal cut-point for 14 days was score ≥3.

Conclusion: The TW-PCST demonstrated a good sensitivity and specificity in identification of inpatients with palliative care needs. A total-ABCD score ≥2 may be considered as a trigger for further referral.

Keywords: Admitted patient; Chronic disease; Palliative care; Referral and consultation; Screening tool.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Chronic Disease / therapy*
  • Female
  • Health Care Surveys
  • Humans
  • Inpatients*
  • Male
  • Middle Aged
  • Needs Assessment*
  • Neoplasms / therapy*
  • Palliative Care*
  • Prospective Studies
  • ROC Curve
  • Referral and Consultation
  • Sensitivity and Specificity
  • Survival Analysis
  • Taiwan / epidemiology
  • Time Factors