Predictions of survival in terminal illness often inaccurate

DOCTORS are "frequently inaccurate" when predicting how long patients with terminal illnesses will survive, according to research published by the Marie Curie Palliative Care Research Department at University College London.

The researchers reviewed 4,642 records from previous studies involving clinical predictions of survival in patients approaching the end of life and found these were often inaccurate, with wide variations ranging from an underestimate of 86 days to an overestimate of 93 days.

The study also identified no clear correlation in accuracy among different types of doctors – for example more experienced or older clinicians were no more accurate than others. More research is now being conducted to identify what makes some doctors better at predicting survival than others. Is it simply intuition or is prognostic accuracy a skill that can be taught?

Paddy Stone, Professor of Palliative and End of life care at the Marie Curie Research Department at UCL, said: "Delivering the most appropriate care and treatments for those with terminal illnesses is often dependent on doctors making an accurate prognosis. Knowing how much time is left can also better equip patients and their carers to make more informed choices about their care.

"This research suggests that there is no simple way to identify which doctors are better at predicting survival. Being more senior or more experienced does not necessarily make one a better prognosticator but we now want to see if we can identify how and why some doctors are better at predicting survival than others and to determine if this is a skill that can be taught."

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