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Calculating Impending Death with Likelihood Ratios and Pretest Probability
See Also: Recursively Developed Model for Impending Death
Applicable to advanced cancer patients admitted to an acute palliative care unit. Has not been validated in other clinical scenarios!
First, using your clinical judgement, guess a percentage estimate that this person will pass away in the next three days. For example, advanced cancer patients admitted to an acute palliative care unit in the study these likelihood ratios (LRs) were derived from had a pretest probabilty of 38% of dying within three days.3
Pre-test Probability: %
Are any of the following present? Definitions can be found below.

Sign Pos LR Neg LR
16.7 0.86
15.6 0.89
15.2 0.77
13.6 0.8
12.4 0.9
11.8 0.82
10.3 0.97
10.0 0.8
9.0 0.8
8.3 0.73
8.3 0.69
7.3 0.82
6.7 0.72


Post-test Probability (of death in the next 72 hrs):

Definitions for signs that may be new:
Sources:
  1. Anderson F, Downing GM, Hill J, Casorso L, Lerch N. Palliative Performance Scale (PPS): A New Tool. J Palliative Care. 1996;12(1):5-11.
  2. Hui D, Hess K, Dos Santos R, et al. A Diagnostic Model for Impending Death in Cancer Patients: Preliminary Report. Cancer 2015;121(21): 3914-3921.
  3. Hui D, Dos Santos R, Chisholm G, et al. Bedside clinical signs associated with impending death in patients with advanced cancer: preliminary findings of a prospective, longitudinal cohort study. Cancer. 2015; 121(6):960-7.
  4. Hui D, Dos Santos R, Chisholm G, et al. Clinical signs of impending death in cancer patients. Oncologist. 2014; 19(6):681-7.