Using the modified Barthel index to estimate survival in cancer patients in hospice: observational study

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Abstract
Professionals in palliative care often base clinical decisions on estimated prognosis, but it has been shown that they are less accurate than the Karnofsky index at predicting prognosis in terminally ill patients. 1 2 Because our clinical experience suggested that in patients in hospice the rate of change in physical functioning was a more useful indicator of survival than absolute measures, we investigated the use of rate of change of physical function in estimating survival of terminally ill patients with cancer by using the modified Barthel index. This comprises 10 activities of daily living, each with five levels of dependency; the maximum score is 100 points, representing independence in daily living. We thought it was a more sensitive index for measuring physical functioning in this patient …