Meta-analysis of survival prediction with palliative performance scale

Michael Downing*, Francis Lau, Mary Lesperance, Nicholas Karlson, Jack Shaw, Craig Kuziemsky, Steve Bernard, Laura Hanson, Lola Olajide, Barbara Head, Christine Ritchie, Joan Harrold, David Casarett

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

123 Citations (Scopus)


This paper aims to reconcile the use of Palliative Performance Scale (PPSv2) for survival prediction in palliative care through an international collaborative study by five research groups. The study involves an individual patient data meta-analysis on 1,808 patients from four original dataseis to reanalyze their survival patterns by age, gender, cancer status, and initial PPS score. Our findings reveal a strong association between PPS and survival across the four dataseis. The KaplanMeier survival curves show each PPS level as distinct, with a strong ordering effect in which higher PPS levels are associated with increased length of survival. Using a stratified Cox proportional hazard model to adjust for study differences, we found females lived significantly longer than males, with a further decrease in hazard for females not diagnosed with cancer. Further work is needed to refine the reporting of survival times/probabilities and to improve prediction accuracy with the inclusion of other variables in the models.

Original languageEnglish
Pages (from-to)245-254
Number of pages10
JournalJournal of Palliative Care
Issue number4
Publication statusPublished - Dec 2007
Externally publishedYes


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