Adding items that assess changes in activities of daily living does not improve the predictive accuracy of the Palliative Prognostic Index

Background:Changes in activities of daily living in cancer patients may predict their survival. The Palliative Prognostic Index is a useful tool to evaluate cancer patients, and adding an item about activities of daily living changes might improve its predictive value.Aim:To clarify whether adding an item about activities of daily living changes improves the accuracy of Palliative Prognostic Index.Design:Multicenter prospective cohort study.Setting:A total of 58 palliative care services in Japan.Participants:Patients aged >20 years diagnosed with locally extensive or metastatic cancer (including hematological neoplasms) who had been admitted to palliative care units, were receiving care by hospital-based palliative care teams, or were receiving home-based palliative care. Palliative care physicians recorded clinical variables at the first assessment and followed up patients 6 months later.Results:A total of 2425 subjects were recruited and 2343 of these had analyzable data. The C-statistic of the original...