PT  - JOURNAL ARTICLE
AU  - Christina Chu
AU  - Nicola White
AU  - Patrick Stone
TI  - Prognostication in palliative care
AID  - 10.7861/clinmedicine.19-4-306
DP  - 2019 Jul 01
TA  - Clinical Medicine
PG  - 306--310
VI  - 19
IP  - 4
4099  - http://www.rcpjournals.org/content/19/4/306.short
4100  - http://www.rcpjournals.org/content/19/4/306.full
SO  - Clin Med2019 Jul 01; 19
AB  - 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.