Prognostic Indices for Advance Care Planning in Primary Care: A Scoping Review

Peter Kim; Jeanette M. Daly; Maresi A. Berry-Stoelzle; Megan E. Schmidt; LeAnn C. Michaels; David A. Dorr; Barcey T. Levy

doi:10.3122/jabfm.2020.02.190173

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Prognostic Indices for Advance Care Planning in Primary Care: A Scoping Review

Journal article

Open access

Prognostic Indices for Advance Care Planning in Primary Care: A Scoping Review

Peter Kim, Jeanette M. Daly, Maresi A. Berry-Stoelzle, Megan E. Schmidt, LeAnn C. Michaels, David A. Dorr and Barcey T. Levy

Journal of the American Board of Family Medicine, Vol.33(2), pp.322-338

03/01/2020

DOI: 10.3122/jabfm.2020.02.190173

PMCID: PMC7772823

PMID: 32179616

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Abstract

Background: Patient identification is an important step for advance care planning (ACP) discussions. Objectives: We conducted a scoping review to identify prognostic indices potentially useful for initiating ACP. Methods: We included studies that developed and/or validated a multivariable prognostic index for all-cause mortality between 6 months and 5 years in community-dwelling adults. PubMed was searched in October 2018 for articles meeting our search criteria. If a systematic review was identified from the search, we checked for additional eligible articles in its references. We abstracted data on population studied, discrimination, calibration, where to find the index, and variables included. Each index was further assessed for clinical usability. Results: We identified 18 articles with a total of 17 unique prognostic indices after screening 9154 titles. The majority of indices (88%) had c-statistics greater than or equal to 0.70. Only 1 index was externally validated. Ten indices, 8 developed in the United States and 2 in the United Kingdom, were considered clinically usable. Conclusion: Of the 17 unique prognostic indices, 10 may be useful for implementation in the primary care setting to identify patients who may benefit from ACP discussions. An index classified as "clinically usable" may not be easy to use because of a large number of variables that are not routinely collected and the need to program the index into the electronic medical record.

General & Internal Medicine

Life Sciences & Biomedicine

Medicine, General & Internal

Primary Health Care

Science & Technology

Details

Title: Subtitle: Prognostic Indices for Advance Care Planning in Primary Care: A Scoping Review
Creators: Peter Kim - Roy J. and Lucille A. Carver College of Medicine
Jeanette M. Daly - Roy J. and Lucille A. Carver College of Medicine
Maresi A. Berry-Stoelzle - Roy J. and Lucille A. Carver College of Medicine
Megan E. Schmidt - Roy J. and Lucille A. Carver College of Medicine
LeAnn C. Michaels - Oregon Hlth & Sci Univ, Oregon Rural Practice Based Res Network, Portland, OR 97201 USA
David A. Dorr - Roy J. and Lucille A. Carver College of Medicine
Barcey T. Levy - Roy J. and Lucille A. Carver College of Medicine
Resource Type: Journal article
Publication Details: Journal of the American Board of Family Medicine, Vol.33(2), pp.322-338
DOI: 10.3122/jabfm.2020.02.190173
PMID: 32179616
PMCID: PMC7772823
NLM abbreviation: J Am Board Fam Med
ISSN: 1557-2625
eISSN: 1558-7118
Publisher: Amer Board Family Medicine
Number of pages: 17
Grant note: Iowa Academy of Family Physicians Endowed Chair for Rural Medicine Fund, Department of Family Medicine, University of Iowa Carver College of Medicine PLC-1609-36277 / Patient-Centered Outcomes Research Institute (PCORI); Patient-Centered Outcomes Research Institute - PCORI
Language: English
Date published: 03/01/2020
Academic Unit: Epidemiology; Family and Community Medicine; Finance
Record Identifier: 9984297449002771

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