{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:52:45Z","timestamp":1787014365062,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,5,8]],"date-time":"2023-05-08T00:00:00Z","timestamp":1683504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Eligibility to access the Victorian voluntary assisted dying (VAD) legislation requires that people have a prognosis of 6 months or less (or 12 months or less in the setting of a neurodegenerative diagnosis). Yet prognostic determination is frequently inaccurate and prompts clinician discomfort. Based on functional capacity and clinical and biochemical markers, prognostic tools have been developed to increase the accuracy of life expectancy predictions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This review of prognostic tools explores their accuracy to determine 6\u2010month mortality in adults when treated under palliative care with a primary diagnosis of cancer (the diagnosis of a large proportion of people who are requesting VAD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search of the literature was performed on electronic databases Medline, Embase and Cinahl.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Limitations of prognostication identified include the following: (i) prognostic tools still provide uncertain prognoses; (ii) prognostic tools have greater accuracy predicting shorter prognoses, such as weeks to months, rather than 6 months; and (iii) functionality was often weighted significantly when calculating prognoses. Challenges of prognostication identified include the following: (i) the area under the curve (a value that represents how well a model can distinguish between two outcomes) cannot be directly interpreted clinically and (ii) difficulties exist related to determining appropriate thresholds of accuracy in this context.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prognostication is a significant aspect of VAD, and the utility of the currently available prognostic tools appears limited but may prompt discussions about prognosis and alternative means (other than prognostic estimates) to identify those eligible for VAD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/imj.16081","type":"journal-article","created":{"date-parts":[[2023,4,8]],"date-time":"2023-04-08T08:19:03Z","timestamp":1680941943000},"page":"2180-2197","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["A review of the utility of prognostic tools in predicting 6\u2010month mortality in cancer patients, conducted in the context of voluntary assisted dying"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7526-8285","authenticated-orcid":false,"given":"Lydia","family":"Treleaven","sequence":"first","affiliation":[{"name":"Department of Medicine The University of Melbourne  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1360-3375","authenticated-orcid":false,"given":"Paul","family":"Komesaroff","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"},{"name":"Department of Medicine Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camille","family":"La Brooy","sequence":"additional","affiliation":[{"name":"School of Public Health and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5478-1576","authenticated-orcid":false,"given":"Ian","family":"Olver","sequence":"additional","affiliation":[{"name":"School of Psychology, Faculty of Health and Medical Sciences University of Adelaide  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian","family":"Kerridge","sequence":"additional","affiliation":[{"name":"Department of Medicine Royal North Shore Hospital  St Leonards New South Wales Australia"},{"name":"Sydney Health Ethics The University of Sydney  Camperdown New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3312-0645","authenticated-orcid":false,"given":"Jennifer","family":"Philip","sequence":"additional","affiliation":[{"name":"Department of Medicine The University of Melbourne  Melbourne Victoria Australia"},{"name":"Palliative Care Service St Vincent's Hospital  Melbourne Victoria Australia"},{"name":"Palliative Care Service Peter MacCallum Cancer Centre, Royal Melbourne Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,5,8]]},"reference":[{"key":"e_1_2_7_2_1","unstructured":"Voluntary Assisted Dying Regulations 2018 [Internet]. Victoria: Victorian Government;2019Jun 19 [cited 2022 Oct 24]. 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