Table 2. Three Approaches to Clinician Prediction of Survival.
Aspects | Temporal Question10,32 |
Surprise Question29,30 |
Probabilistic Question10,32 |
---|---|---|---|
Question | How long will this patient live? |
Would I be surprised if this patient died in (specific time frame)? |
What is the probability of survival within a specific time frame |
Answer | Specific time frame |
Yes or no | 0% to 100% (at 10% increments) |
Definition of an accurate response |
If estimated time frame was ± 33% of actual survival |
If “no” answer and patient died within specified time frame or If “yes” answer patient remained alive by specified time frame |
If answered ≤ 30% probability and patient died within specified time frame or If answered ≥ 70% probability and patient remained alive by specified time frame |
Accuracy | 20%–30% | 76%–88% (1 year time frame) |
53%–91% (6 months to 24-h time frames) |
Advantage | Simple, quick Intuitive to provide Understand |
Simple, quick Intuitive to understand |
Simple, quick |
Disadvantage | Subjective Unclear if time frame represents the average/median, maximal or minimal May be difficult emotionally to provide a specific number |
Subjective Time frame dependent The threshold for “surprise” may vary by individual Yes/no answer only |
Subjective Time frame dependent Probability needs to be interpreted |