Skip to main content

ePrognosis 2.0: PPS and Cancer screening



by: Alex Smith, @AlexSmithMD

The geriatrics, general medicine, and palliative care communities have spoken, and we've been listening.

ePrognosis is the website we created to help clinicians in everyday practice calculate prognosis or life expectancy.  Two things we've heard over and over about how we could improve ePrognosis:
  1. "We want the PPS!"  "The Palliative Performance Scale (PPS) is likely the most widely used prognostic scale in hospice and palliative care, why isn't it on ePrognosis?"  "ePrognosis doesn't have any really short term prognostic calculators."
  2. "ePrognosis the app in the iTunes store is great, but I'm not an apple person.  Can't you make something like that for android?"
 In response to this feedback, we're excited to announce the addition of the PPS and ePrognosis: Cancer Screening to our website.  Key features of the PPS:
  1. From the main page, you can get to the PPS one of 3 ways.  We did this in order to leverage recent validation studies that have examined the PPS in large but distinct populations:
    1. By selecting that your patient is in hospice
    2. By selecting hospital, then palliative care consult
    3. By selecting clinic, prognosis less than 1 year, and advanced cancer
  2. Outcomes from the PPS will vary depending on your selection above.  So entering the same risk information in the PPS for a patient in hospice will result in a shorter prognosis than entering the same information for a clinic patient with advanced cancer.  This is because the prognosis in the validation studies varied by score depending on the population studied (hospitalized, hospice, outpatient with cancer).  If you think about it, this makes sense.
  

Key features of the cancer screening website:
  1. You can get to the cancer screening website by clicking on the icon in the center of the page, or the link "Cancer screening" in the upper right of the main page.
  2. You can use the website on any mobile or tablet, apple or andoid.
  3. We're very happy with the new design of the cancer screening website.  Websites are increasingly going to this look, with big images and horizontal scrolling. We will soon be converting most of ePrognosis to this look.


We're listening.  Let us know what you think.  

And look for more new updates soon (spoiler alert: video of Eric Widera having a code status discussion)

Comments

何眀晋 said…
This comment has been removed by a blog administrator.

Popular posts from this blog

Practical Advice for the End of Life: A Podcast with BJ Miller

This week we talk with BJ Miller, hospice and palliative care physician, public speaker, and now author with Shoshana Berger of the book "A Beginner's Guide to the End."

As we note on the podcast, BJ is about as close as we get to a celebrity in Hospice and Palliative Care.  His TED Talk "What Really Matters at the End of Life" has been viewed more than 9 million times.  As we discuss on the Podcast, this has changed BJ's life, and he spends most of his working time engaged in public speaking, being the public "face" of the hospice and palliative care movement.

The book he and Berger wrote is filled to the brim with practical advice.  I mean, nuts and bolts practical advice.  Things like:
How to clean out not only your emotional house but your physical house (turns out there are services for that!)Posting about your illness on social media (should you post to Facebook)What is the difference between a funeral home and mortuaryCan I afford to die?  …

Improving Advance Care Planning for Latinos with Cancer: A Podcast with Fischer and Fink

In this week's GeriPal podcast we talk with Stacy Fischer, MD and Regina Fink, RN, PhD, both from the University of Colorado, about a lay health navigator intervention to improve advance care planning with Latinos with advanced cancer.  The issue of lay health navigators raises several issues that we discuss, including:
What is a lay health navigator?What do they do?  How are they trained?What do lay health navigators offer that specialized palliative care doesn't?  Are they replacing us?What makes the health navigator intervention particularly appropriate for Latinos and rural individuals?  For advance care planning? Eric and I had fun singing in French (yes French, not Spanish, listen to the podcast to learn why).
Enjoy! -@AlexSmithMD




You can also find us onYoutube!



Listen to GeriPal Podcasts on:
iTunes Google Play MusicSoundcloudStitcher

Transcript

Eric: Welcome to the GeriPal podcast. This is Eric Widera.

Alex: This is Alex Smith.

Eric: And Alex, I'm really excited about toda…

The Dangers of Fleet Enemas

The dangers of oral sodium phosphate preparations are fairly well known in the medical community. In 2006 the FDA issued it’s first warning that patients taking oral sodium phosphate preparations are at risk for potential for acute kidney injury. Two years later, over-the-counter preparations of these drugs were voluntarily withdrawn by the manufacturers.  Those agents still available by prescription were given black box warnings mainly due to acute phosphate nephropathy that can result in renal failure, especially in older adults. Despite all this talk of oral preparations, little was mentioned about a sodium phosphate preparation that is still available over-the-counter – the Fleet enema.

Why Oral Sodium Phosphate Preparations Are Dangerous 

Before we go into the risks of Fleet enemas, lets spend just a couple sentences on why oral sodium phosphate preparations carry significant risks. First, oral sodium phosphate preparations can cause significant fluid shifts within the colon …