PP-10 An international consensus study to develop a core outcome set to evaluate the impact of prognostication in people living with advanced cancer

Introduction

Evaluating the impact of prognostic models in advanced cancer is challenging due to inconsistent outcome reporting and limited consideration of patient and caregiver perspectives. We have therefore developed a Core Outcome Set (COS), to assist with standardising the evaluation of prognostication in advanced cancer.

Aims

To achieve consensus on the most important outcomes for assessing the impact of prognostication on people living with advanced cancer.

Methods

We identified 67 outcomes from a systematic review and interviews and prioritised them through a two-round international Delphi survey involving four key stakeholder groups: patients, caregivers, clinicians, and researchers. Participants rated outcomes on a 9-point Likert scale (1–3: not important; 4–6: important but not critical; 7–9: critical). Outcomes rated as critical by ≥70% and not important by ≤15% were retained and discussed in an online consensus meeting which finalised the COS.

Results

A total of 31 participants (4 patients, 5 caregivers, 15 clinicians, 7 researchers) completed both Delphi rounds, with 12 (2 patients, 2 caregivers, 5 clinicians, 3 researchers) attending the consensus meeting. Thirty-four of the 67 were rated as critical, and 9 reached consensus for inclusion in the COS: physical functioning, psychological/mental status, quality of life, treatment/care preferences, end-of-life/advance care planning, place of care, quality of death, prognostic understanding, and practical/logistical preparation for end-of-life.

Conclusion

This is the first COS for evaluating the impact of prognostication in people living with advanced cancer. Its implementation in future prognostic studies might reduce outcome redundancy and enable better comparisons between prognostic models.

Impact

This COS addresses the lack of standardisation in prognostic studies for advanced cancer. It prioritises patient- and caregiver-centred outcomes and may make comparing outcomes across studies easier. Its use might enhance the consistency and relevance of future research, leading to more informed decision-making and improved care for individuals living with advanced cancer.'