{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T06:16:39Z","timestamp":1781244999732,"version":"3.54.1"},"reference-count":39,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2018,9,16]],"date-time":"2018-09-16T00:00:00Z","timestamp":1537056000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Chron Respir Dis"],"published-print":{"date-parts":[[2019,1,1]]},"abstract":"<jats:p>Currently, few patients suffering from chronic obstructive pulmonary disease (COPD) who might benefit from a palliative care approach are referred to a palliative care team. Tools to identify patients eligible for a palliative care approach have been found to be difficult to apply in daily practice. Therefore, there is need for a simple and easily applicable tool to identify those patients who would benefit from referral to a palliative care team. The aim of this study was to determine if the surprise question (SQ) \u201cWould I be surprised if this patient dies within 12 months?\u201d in a subset of recently hospitalized COPD patients identifies those subjects. Recently hospitalized COPD patients were included, and the answer to the SQ was provided by the treating pulmonologist. The gold standards framework (GSF) prognostic indicator guidance was regarded as the gold standard test and was assessed for each patient. Sensitivity, specificity, and negative and positive predictive values were calculated to determine the accuracy of the SQ plus recent hospitalization compared to the variables of the GSF. A total of 93 patients were analyzed. In 35 patients (38%), the answer to the SQ was \u201cnot surprised\u201d; 78 patients (84%) met \u22651 criteria of the GSF (15 (16%) did not meet any criteria). Specificity and positive predictive value for the SQ were both 100% ((78.2\u2013100) and (87.7\u2013100), respectively). Sensitivity was 44.9% (33.7\u201356.5) and negative predictive value was 25.9% (22.2\u201329.9). The \u201cnot surprised\u201d group fulfilled significantly more GSF criteria. The SQ after recent hospitalization for COPD has a very high specificity compared to a standardized tool and is therefore a useful tool for the quick identification of patients who are most likely to benefit from palliative care. However, this method doesn\u2019t identify all patients who are eligible for referral to palliative care.<\/jats:p>","DOI":"10.1177\/1479972318796219","type":"journal-article","created":{"date-parts":[[2018,9,17]],"date-time":"2018-09-17T00:25:31Z","timestamp":1537143931000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":14,"title":["COPD patients in need of palliative care: Identification after hospitalization through the surprise question"],"prefix":"10.1177","volume":"16","author":[{"given":"Dionne","family":"Noppe","sequence":"first","affiliation":[{"name":"Spaarne Gasthuis, Haarlem, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans in \u2018t","family":"Veen","sequence":"additional","affiliation":[{"name":"Franciscus Gasthuis, Rotterdam, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7815-0488","authenticated-orcid":false,"given":"Kris","family":"Mooren","sequence":"additional","affiliation":[{"name":"Spaarne Gasthuis, Haarlem, the Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,9,16]]},"reference":[{"key":"bibr1-1479972318796219","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61728-0"},{"key":"bibr2-1479972318796219","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.55.12.1000"},{"key":"bibr3-1479972318796219","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2003.11.006"},{"key":"bibr4-1479972318796219","doi-asserted-by":"publisher","DOI":"10.1177\/0269216310375861"},{"key":"bibr5-1479972318796219","doi-asserted-by":"publisher","DOI":"10.1177\/0269216310363650"},{"key":"bibr6-1479972318796219","first-page":"325","volume":"25","author":"Royal College of Physicians (Research Unit)","year":"1991","journal-title":"J R Coll Physicians Lond"},{"key":"bibr7-1479972318796219","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.04.00010104"},{"key":"bibr8-1479972318796219","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.154.6.8970363"},{"key":"bibr9-1479972318796219","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.3.326"},{"key":"bibr10-1479972318796219","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2010.0347"},{"key":"bibr11-1479972318796219","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcrj.2006.08.008"},{"key":"bibr12-1479972318796219","doi-asserted-by":"publisher","DOI":"10.1111\/j.1752-699X.2009.00177.x"},{"key":"bibr13-1479972318796219","unstructured":"Thomas K, Wilson Armstrong J GSF Team The GSF prognostic indicator guidance. 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