Table 3.

Description of measurement properties of included studies

Instrument	Study Design and authors	Measurement properties reported Study population, N Country	Age mean (SD, range)	Gender % women Setting % NH	Results of measurement properties	Proportion of patients in need of palliative care
NECPAL	Development and prevalence study (Gomez-Batiste et al)44	Development and content validity Participants: doctors, nurses, social workers, and psychologists, experts in palliative care, N=18 Spain	NR	NR	Development & content validity Translation, cultural and clinical adaptation of relevant items of GSF PIG and SPICT were accomplished with three rounds of expert consultations. Appropriateness, comprehensiveness, and feasibility were assessed through interviews.	N/A
		Face validity & comprehension Participants: doctors, nurses, social workers, and psychologists, experts in palliative care, N=18 Spain	NR	NR	Face validity & comprehension 18 interviews performed for comprehension and face validity in primary care settings with five versions of the tool	N/A
		Prevalence & Feasibility Patients with advanced chronic conditions from nine different care services (3 primary care services, 4 nursing homes, 1 hospital, 1 social-health center), N=1,064 Spain	81.7 years (SD 12) for the SQ+ patients	61.5% of the SQ+ sample were women 22.1% of the SQ+ sample were NH residents	Feasibility Assessed through two focus groups of eight multidisciplinary healthcare professionals	Prevalence 70.5% of patients with chronic conditions were surprise question positive 64.3% of patients with chronic conditions were NECPAL+ indicating unmet palliative care needs. 91.2% of SQ+ patients with chronic conditions were NECPAL+ 7% of population >65 years of age were NECPAL+.
	Prevalence and correlational study (Esteban-Burgos et al)45	Hypothesis testing for construct validity Participants: Complex chronic patients with cancer, dementia, specific organ failure, N=149, (7 nursing homes) Spain	84.5 years (SD 9) total sample	67.1% women total sample 100% of the total sample were NH residents	Hypothesis testing for construct validity Case Complexity Index (CaCI) Spearman correlation 0.133 (NS) with NECPAL+	N/A
		Hypothesis testing for construct validity Participants: Complex chronic patients with cancer, dementia, specific organ failure, N=149, (7 nursing homes) Spain	84.5 years (SD 9) total sample	67.1% women total sample 100% of the total sample were NH residents	Hypothesis testing for construct validity Frail-VIG Spearman correlation +0.405 (p<.01) with NECPAL+	N/A
		Hypothesis testing for construct validity Participants: Complex chronic patients with cancer, dementia, specific organ failure, N=149, (7 nursing homes) Spain	84.5 years (SD 9) total sample	67.1% women total sample 100% of the total sample were NH residents	Hypothesis testing for construct validity IDCPal+ Spearman correlation +0.375 (p<.01) with NECPAL+	N/A
		Hypothesis testing for construct validity Participants: Complex chronic patients with cancer, dementia, specific organ failure, N=149, (7 nursing homes) Spain	84.5 years (SD 9) total sample	67.1% women total sample 100% of the total sample were NH residents	Hypothesis testing for construct validity PPS Spearman correlation −0.374 (p<.01) with NECPAL+	N/A
		Hypothesis testing for construct validity Participants: Complex chronic patients with cancer, dementia, specific organ failure, N=149, (7 nursing homes) Spain	84.5 years (SD 9) total sample	67.1% women total sample 100% of the total sample were NH residents	Hypothesis testing for construct validity PPI Spearman correlation +0.444 (p<.01) with NECPAL+	N/A
		Prevalence Participants: Complex chronic patients with cancer, dementia, specific organ failure, N=149, (7 nursing homes) Spain	84.5 years (SD 9) total sample	67.1% women total sample 100% of the total sample were NH residents	Prevalence Assessed with positive surprise question	Prevalence 53% of complex chronic residents were SQ+ Prevalence of NECPAL+ not reported

SD, standard deviation; NR, not reported; SQ+, surprise question positive; NECPAL+, positive screen for palliative care needs; ICDPal+, positive screen for palliative care complexity