Owusuaa et al reported a nomogram for predicting 1-year mortality for a patient with advanced cancer. The authors are from multiple institutions in the Netherlands.
Patient selection: advanced cancer
Parameters:
(1) surprise question
(2) age in years, from 20 to 90
(3) prognostic type of cancer (good prognosis was seen with breast, prostate and thyroid)
(4) visceral metastasis
(5) brain metastasis
(6) ECOG performance score
(7) weight loss in past 6 months
(8) pain score as 10-cm VAS
(9) grade of dyspnea using CTCAE
(10) hemoglobin in mmol/L
(11) serum CRP in mg/L
(12) serum albumin in g/L
points for age =
= (0.591 * (age)) - 11.828
points for pain =
= 2.78 * (pain)
points for hemoglobin =
= 79.2 - (9.9 * (hemoglobin))
points for CRP =
= (14.23 * LN(CRP)) + 9.874
points for serum albumin =
= 99.856 - (1.815 * (albumin))
|
Parameter
|
Finding
|
Points
|
|
surprise question
|
yes
|
0
|
|
|
no
|
100
|
|
cancer prognosis
|
good
|
0
|
|
|
poor
|
25.4
|
|
visceral metastasis
|
no
|
0
|
|
|
yes
|
20.1
|
|
brain metastasis
|
no
|
0
|
|
|
yes
|
33.7
|
|
ECOG performance
|
0
|
1.8
|
|
|
1
|
0
|
|
|
2 to 4
|
28.4
|
|
weight loss
|
none
|
0
|
|
|
any
|
7.7
|
|
dyspnea
|
Grade 0
|
0
|
|
|
Grade 1
|
16
|
|
|
Grade 2 or more
|
22.5
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 518.8
value of X =
= (0.0000301 * ((score)^2)) + (0.0047 * (score)) - 2.73
probability of 1-year mortality =
= 1 / (1+ EXP((-1) * X))
Performance:
• The C-statistic for the extended model was 0.78.
