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.
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