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Friday, September 2, 2011

Prognostication in cancer

We're blogging from a mobile today so links are at the bottom of this post.

Thanks to our friends at the and the National Cancer Research Institute for directing us to these two articles in the British Medical Journal.

The first is a research paper whose abstract states the objective of the prospective study as being: "To develop a novel prognostic indicator for use in patients with advanced cancer that is significantly better than clinicians’ estimates of survival."

Looking at the prognostic value of a number of clinical and laboratory observations in 1018 patients with advanced or metastatic cancer referred for palliative care, they were able to determine a number of variables predictive of two week and two month survival with equal or greater accuracy than clinicians' estimates.

The responses address data which might further illuminate these findings and patient responses to being given survival estimates.

The second is an editorial (extract of which is free to read if your network does not enable you to get full access) referring to this research whilst lamenting the current state of prognostication as a skill in healthcare.

Having worked at one tertiary referral centre (Bart's in London) where prognosis was discussed with patients often on the basis of a database of the patient population for that centre going back thirty years it's interesting to reflect on how unique that facility was.

National Cancer Intelligence Network

Research paper from the BMJ Editorial from the BMJ

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