Prognosis Superspecial: A Podcast with Kara Bischoff, James Deardorff, and Elizabeth Lilley
episode
GeriPal - A Geriatrics and Palliative Medicine Podcast
49 min
2 speakers
4 chapters
transcribed 9 hours ago
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What is the purpose of the Prognosis Super‑Special episode and who are the guests?
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Welcome to the Jerry Powell podcast. This is Eric Radera.
This is Alex Smith.
At Alex, we have a super special today. Three different articles.
Prognosis super special today. And we have some great guests. First time on the Jerry Powell podcast, Liz Lilly, who's a surgeon in faculty in surgery at the Brigham Women's Hospital and Harvard Medical School. Liz, welcome to the Jerry Powell podcast.
Thanks. Good to be here.
And we have two returning guests. First we have James Dierdorf, who's a geriatrician and assistant professor at UCSF in the Division of Geriatrics. James, welcome back to Jerry Powell. Thanks for
having me.
And we have returning guest Kara Bischoff, who's a palliative care doc and associate professor at UCSF in the Division of Palliative Medicine. Welcome back to Jerry Powell.
Thanks so much, Alex.
So we got three articles to talk about about prognostication and prognosis. But before we do, we always ask for a song request, Liz. I think you got the song.
I do have the song. Uh the song request is What Was I Made For by Billy Eilish from the very fabulous Barbie movie.
Why did you pick this song?
I think that when patients think about or when we think about prognostication, there's a lot of uncertainty and some existential distress sometimes. And I think that this song kind of captures some of that distress.
In addition to wanting to torture me with uh female singer songwriter Diva. Which I secretly enjoy. The challenge of All right, here's a little bit. This is uh yeah, I didn't see the Barbie movie but okay, here we go.
I used to float, now I just fall down. I used to know. But I'm not sure now what I was made for. What was I made for? Taking a drive, I was an ID, looked so alive. Turns out I'm not real, just something you paid for. What was I made for? Because I Ah I don't know how to feel. But Wanna try I don't know how to feel. But someday I might Sunday.
Alex says you're torturing him but I just know he loves a song 'cause he continues to play
the extended intro version. Thank you for that opportunity, Liz.
Well done.
So we got a lot to cover um prognosis. We're gonna be talking about three different articles, one on the PPS. Um we'll talk about what that is. Uh another one on thinking about prognostication in nursing home patients with dementia. Or whether or not they're going to be admitted to a nursing home. And the third one on prognostic uh alignment. So I was thinking about starting off with uh the PPS, uh the palliative performance skill. Is that right, Cara?
That's right, you got it.
Um, why is the PPS important?
Sure. Yeah. So the palliative performance scale or PPS is essentially a tool to help clinicians with prognostication for seriously ill or palliative care populations. It's essentially a measure of functional status. It's modeled off the Karnowsky performance scale, but it was adapted for palliative care populations. It was developed in um Canadian palliative care units in the nineteen nineties, about thirty years ago, but it's still the prognostic tool mo used most often by palliative care clinicians.
Yeah, I see it used on inpatient side, on consult clinics, in hospices. A lot of people use the PPS when they're thinking about function. And then aligning that with prognosis. Most
used Prognostic index on e prognosis. Oh really? Most used.
Most used. Out of all the ones. Out of
all those indices. Why
do you think that is?
About 12,000 views per month. I think it's just um, you know, it is appropriate for all patient populations. Um, and it is developed specifically for the palliative care and hospice populations. Um, and it's pretty straightforward. It's pretty easy to use by clinicians in the course of care.
I suspect that e-prognosis gets a lot of hits because we have simple, easy to use drop down menus and there are all these skip patterns in estimating the PPS. And so we make it really easy for clinicians to to use it. That's a suspicion. My other suspicion is that hospices are using it for recertification because it predicts such a short-term mortality.
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Chapters
4 chapters
1
What is the purpose of the Prognosis Super‑Special episode and who are the guests?
0:00–16:56
2
Why is the Palliative Performance Scale (PPS) still used and what are its limitations?
16:56–30:12
3
How did the UCSF team re‑validate the PPS for modern outpatient palliative care?
30:12–39:50
4
What does the new PPS validation reveal about survival estimates for seriously ill patients?
39:50–49:08
Speakers
2 identifiedMore from GeriPal - A Geriatrics and Palliative Medicine Podcast
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