Parameters:
(1) diagnosis
(2) ECOG functional status
(3) complications of advanced cancer associated with life-expectancy less than 12 months (brain metastases, cachexia, etc)
(4) severe comorbid disease with life-expectancy less than 12 months (end-stage renal disease, cirrhosis, etc)
(5) control of symptoms by standard approaches
(6) distress related to diagnosis or therapy
(7) concerns about course of disease and decision making
(8) patient/family request for palliative care consultation team
(9) need of team for assistance with complex decision making or determining goal of care
(10) length of stay
|
Parameter
|
Finding
|
Points
|
|
diagnosis
|
metastatic or locally advanced cancer
|
2
|
|
|
other
|
0
|
|
ECOG status
|
ECOG 0
|
0
|
|
|
ECOG 1
|
1
|
|
|
ECOG 2
|
2
|
|
|
ECOG 3
|
3
|
|
|
ECOG 4
|
4
|
|
number of complications of advanced cancer
|
0
|
0
|
|
|
>= 1
|
1
|
|
number of severe comorbid conditions
|
0
|
0
|
|
|
>= 1
|
1
|
|
control of symptoms by standard means
|
no
|
1
|
|
|
yes
|
0
|
|
distress
|
no
|
0
|
|
|
yes
|
1
|
|
concerns
|
no
|
0
|
|
|
yes
|
1
|
|
request for palliative care consultation
|
no
|
0
|
|
|
yes
|
1
|
|
complex decision making or goal setting
|
no
|
0
|
|
|
yes
|
1
|
|
length of stay
|
normal
|
0
|
|
|
prolonged
|
1
|
where:
• The scoring for the diagnosis could be pulled out if advanced cancer is the condition for performing the screen.
• A life expectancy less than 12 months replaces asking "surprise" questions.
total score =
= SUM(points for all 10 parameters)
Interpretation:
• minimum score: 0
• maximum score: 14
• A score >= 5 was associated with a need for specialized palliative care.
