Bioethics Blogs

“Surprise Question” Performs Poorly to Predict Death

New research in the CMAJ shows that the commonly used “surprise question” does not work well.

The surprise question is intended to be a simple and feasible screening test to identify patients with hospice and palliative care needs.  It involves a clinician reflecting on the question,
“Would I be surprised if this patient died in the next 12 months?”

But the surprise question performs poorly to modestly when used to predict death at 6 to 18  months, with even poorer performance among patients with non-cancer illness. The authors conclude that the surprise question should not be used as a stand-alone prognostic tool.

The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.