{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:10:07Z","timestamp":1760058607231,"version":"build-2065373602"},"reference-count":47,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T00:00:00Z","timestamp":1744675200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Heidelberg University"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background\/Objectives: Patients with haematological malignancies less frequently receive specialist palliative care, although they may have unmet needs for symptom control and alleviating psychosocial and existential burdens. The \u2018Surprise\u2019 Question, \u2018Would you be surprised if this patient died in the next 12 months?\u2019, helps physicians to identify patients who may benefit from palliative care. We tested the influencing factors of the feasibility of the \u2018Surprise\u2019 Question in haemato-oncology outpatients. Methods: We performed a prospective cohort study comparing patients with solid tumours and haematological malignancies. All the patients in the haemato-oncology outpatient clinics of a German university hospital were screened by haemato-oncologists using the \u2018Surprise\u2019 Question. Results: A survival analysis was performed on 672 patients (76% with haematological malignancies) at 3 and 12 months. Within one year, 110 patients (16%) died. Of these, 30\/52 (58%) were patients with solid tumours, but only 12\/53 (23%) patients with haematological malignancies were identified in advance by the \u2018Surprise\u2019 Question, which reflects ambiguous test sensitivity. A substantial part of the haematology patients in their last year of life were not identified (77%). The match between the survival estimates and actual outcomes was fair (Cohen\u2019s kappa 0.37). The proximity from prediction to event and the estimating physician rather than patient characteristics influenced the accuracy of the instrument. Conclusions: For the first time, the feasibility of the \u2018Surprise\u2019 Question in haematology outpatients was proven. Factors that would improve haemato-oncologists\u2019 clinical intuition should be further explored to facilitate timely conversations about issues important to patients nearing the end of life.<\/jats:p>","DOI":"10.3390\/cancers17081326","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T06:50:27Z","timestamp":1744699827000},"page":"1326","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The \u2018Surprise\u2019 Question in Haemato-Oncology: The Estimating Physician and Time to Death Reduce the Prognostic Uncertainty\u2014An Observational Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2182-9427","authenticated-orcid":false,"given":"Christina","family":"Gerlach","sequence":"first","affiliation":[{"name":"Department of Palliative Medicine, Heidelberg University Hospital, 69120 Heidelberg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Weber","sequence":"additional","affiliation":[{"name":"Interdisciplinary Department of Palliative Care, III. Medical Clinic & Polyclinic, University Medical Center Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Schmidtmann","sequence":"additional","affiliation":[{"name":"Institute of Medical Biostatistics Epidemiology and Informatics (IMBEI), University Medical Center Mainz, 55118 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,15]]},"reference":[{"key":"ref_1","unstructured":"Cancer IAfRo (2024, July 14). Prognostizierte Anzahl von Krebstodesf\u00e4llen Weltweit im Zeitraum von 2022 bis 2050 [Graph] Statista. Available online: https:\/\/de.statista.com\/statistik\/daten\/studie\/1201305\/umfrage\/prognostizierte-anzahl-von-krebstodesfaellen-weltweit\/."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Howell, D.A., Roman, E., Cox, H., Smith, A.G., Patmore, R., Garry, A.C., and Howard, M.R. (2010). Destined to die in hospital? 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