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Table 3 Individual study diagnostic test results

From: How accurate is the ‘Surprise Question’ at identifying patients at the end of life? A systematic review and meta-analysis

First author

SQ time frame

Total (n)

SQ responses

Diagnostic test results

SQ

n

Died (n)

Survived (n)

Sensitivity

Specificity

PPV

NPV

c-statistic

% (95% CI)

SQ up to 12 months

Amro [18]

12 months

201

No

50

22

28

56.4

82.7

44

88.7

0.696

   

Yes

151

17

134

(39.6–72.2)

(76–88.2)

(30–58.7)

(82.6–93.3)

(0.612–0.78)

Carmen [19]

12 months

49

No

20

7

13

77.8

67.5

35

93.1

0.726

   

Yes

29

2

27

(40–97.2)

(50.9–81.4)

(15.4–59.2)

(77.2–99.2)

(0.565–0.888)

Feyi [21]

6–12 months

178

No

58

37

21

72.5

83.5

63.8

88.3

0.78

   

Yes

120

14

106

(58.3–84.1)

(75.8–89.5)

(50.1–76)

(81.2–93.5)

(0.71–0.85)

Halbe [22]

12 months

651

No

139

71

68

65.7

87.5

51.1

92.8

0.766

   

Yes

512

37

475

(56–74.6)

(84.4–90.1)

(42.5–59.6)

(90.2–94.9)

(0.719–0.813)

Moroni [25]

12 months

231

No

126

87

39

83.7

69.3

69

83.8

0.765

   

Yes

105

17

88

(75.1–90.2)

(60.5–77.2)

(60.2–77)

(75.3–90.3)

(0.711–0.819)

Moss [26]

12 months

147

No

34

10

24

45.5

80.8

29.4

89.4

0.631

   

Yes

113

12

101

(24.4–67.8)

(72.8–87.3)

(15.1–47.5)

(82.2–94.4)

(0.519–0.743)

Moss [27]

12 months

826

No

131

53

78

74.6

89.7

40.5

97.4

0.822

   

Yes

695

18

677

(62.9–84.2)

(87.3–91.7)

(32–49.4)

(95.9–98.5)

(0.769–0.874)

O'Callaghan [28]

12 months

501

No

99

67

32

62.6

91.9

67.7

90

0.772

   

Yes

402

40

362

(52.7–71.8)

(88.7–94.4)

(57.5–76.7)

(86.7–92.8)

(0.724–0.82)

Pang [29]

12 months

367

No

109

27

82

61.4

74.6

24.8

93.4

0.68

   

Yes

258

17

241

(45.5–75.6)

(69.5–79.3)

(17–34)

(89.7–96.1)

(0.603–0.756)

Thiagarajan [33]

12 months

130

No

83

47

36

75.8

47.1

56.6

68.1

0.614

   

Yes

47

15

32

(63.3–85.8)

(34.8–59.6)

(45.3–67.5)

(52.9–80.9)

(0.534–0.695)

Vick [34]

12 months

4617

No

796

374

422

58.3

89.4

47

93

0.739

   

Yes

3821

267

3554

(54.4–62.2)

(88.4–90.3)

(43.5–50.5)

(92.2–93.8)

(0.719–0.758)

Fenning [30]

6–12 months

172

No

38

6

32

35.3

79.4

15.8

91.8

0.573

   

Yes

134

11

123

(14.2–61.7)

(72.1–85.4)

(6.02–31.3)

(85.8–95.8)

(.452,– .695)

Barnes [35]

12 months

231

No

14

11

3

11.6

97.8

78.6

61.3

0.547

   

Yes

217

84

133

(5.92–19.8)

(93.7–99.5)

(49.2–95.3)

(54.5–67.8)

(0.512–0.581)

South [32]

6–12 months

199

No

96

14

82

93.3

55.4

14.6

99

0.744

   

Yes

103

1

102

(68.1–99.8)

(47.9–62.7)

(8.21–23.3)

(94.7–100)

(0.669–0.818)

Haga [15]

6–12 months

138

No

120

39

81

88.6

13.8

32.5

72.2

0.512

   

Yes

18

5

13

(75.4–96.2)

(7.57–22.5)

(24.2–41.7)

(46.5–90.3)

(0.453–0.571)

Da Silva [40]

12 months

3896

No

938

281

657

49.6

80.3

30

90.4

0.65

   

Yes

2958

285

2673

(45.5–53.8)

(78.9–81.6)

(27–33)

(89.2–91.4)

(0.628–0.671)

SQ up to 6 months

Cohen [20]

6 months

450

No

71

39

32

37.9

90.8

54.9

83.1

0.643

   

Yes

379

64

315

(28.5–48)

(87.2–93.6)

(42.7–66.8)

(79–86.7)

(0.594–0.693)

Khan [44]

6 months

500

No

238

148

90

82.2

71.9

62.2

87.8

0.77

   

Yes

262

32

230

(75.8–87.5)

(66.6–76.7)

(55.7–68.4)

(83.2–91.5)

(0.733–0.808)

O'Callaghan [28]

6 months

501

No

99

56

43

72.7

89.9

56.6

94.8

0.813

   

Yes

402

21

381

(61.4–82.3)

(86.6–92.6)

(46.2–66.5)

(92.1–96.7)

(0.761–0.865)

Gopinathan [31]

6 months

39

No

19

5

14

83.3

57.6

26.3

95

0.705

   

Yes

20

1

19

(35.9–99.6)

(39.2–74.5)

(9.15–51.2)

(75.1–99.9)

(0.52–0.889)

SQ imminent

Gibbins [41]

Admission

6642

No

327

215

112

57

98.2

65.7

97.4

0.776

   

Yes

6315

162

6153

(51.9–62.1)

(97.9–98.5)

(60.3–70.9)

(97–97.8)

(0.751–0.801)

Hamano [23]

7 days

2361

No

931

282

649

84.7

68

30.3

96.4

0.763

   

Yes

1430

51

1379

(80.4–88.4)

(65.9–70)

(27.4–33.4)

(95.3–97.3)

(0.742–0.785)

Hamano [23]

30 days

2361

No

1851

1066

785

95.6

37

57.6

90.4

0.663

   

Yes

510

49

461

(94.2–96.7)

(34.3–39.7)

(55.3–59.9)

(87.5–92.8)

(0.648–0.678)

Strout [42]

30 days

330

No

108

15

93

48.4

68.9

13.9

92.8

0.586

   

Yes

222

16

206

(30.2–66.9)

(63.3–74.1)

(7.99–21.9)

(88.6–95.8)

(0.493–0.68)

  1. Sensitivity (the ability to recognise those who were dying, e.g. 15/31 for study by Strout [42])
  2. Specificity (the ability to recognise those who were not dying, e.g. 206/299 for study by Strout [42])
  3. PPV positive predictive value (the proportion of patients who died when the clinician predicted dying, e.g. 15/108 for study by Strout [42]), NPV negative predictive value (the proportion of patients who survived when the clinician predicted survival, e.g. 206/222 for study by Strout [42])