In this Editorial published in BMJ Quality & Safety, Major and Aphinyanaphongs discuss the challenges in translating mortality risk to the point of care.
Despite advances in medicine, prognostication remains inaccurate for many patients. Physicians tend to overestimate survival, even in advanced cancer and terminal illness groups. Over half of terminally ill patients express they do not want prolonging of life if their quality of life would decline.
End-of-life interventions such as advanced care planning have shown improved adherence to patient’s wishes, improvement in satisfaction and reductions in stress, anxiety and depression, but clinicians remain reluctant to initiate end-of-life discussions with terminal patients if they are currently asymptomatic.
Automated systems can complement clinician judgement to prompt earlier end-of-life discussions.