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

Table 4 Surprise Question accuracy by profession

Total		Died	Survived	Sensitivity	Specificity	PPV	NPV	c-statistic
Doctors
No	218	71 (33)	147 (67)
Yes	442	26 (6)	416 (94)	73	74	33	94	0.735
Total	660	97 (15)	563 (85)	(63–82)	(70–78)	(26–39)	(92–96)	(0.688–0.783)
Nurses
No	720	210 (29)	510 (71)
Yes	2516	259 (10)	2257 (90)	45	82	29	90	0.632
Total	3236	469 (14)	2767 (86)	(40–49)	(80–83)	(26–33)	(86–91)	(0.608–0.655)

Sensitivity (the ability to recognise those who were dying, e.g. 71/97 for doctors)
Specificity (the ability to recognise those who were not dying, e.g. 26/97 for doctors)
PPV positive predictive value, the proportion of patients who died when the clinician predicted dying, e.g. 71/218 for doctors), NPV negative predictive value, the proportion of patients who survived when the clinician predicted survival, e.g. 416/442 for doctors)

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