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Research Letter
October 03, 2016

Estimating 1-Year Mortality for High-Risk Primary Care Patients Using the “Surprise” Question

Author Affiliations
  • 1Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts
  • 2Ariadne Labs, Brigham and Women's Hospital and Harvard School of Public Health, Boston, Massachusetts
  • 3Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
  • 4Francis Weld Peabody Society, Harvard Medical School, Boston, Massachusetts
  • 5Department of Psychiatry, Brigham and Women’s Hospital, Boston, Massachusetts
  • 6Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
  • 7Departments of Emergency Medicine and Health Care Policy, Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. Published online October 3, 2016. doi:10.1001/jamainternmed.2016.5928

Palliative care improves the value of care for seriously ill patients, but resource constraints necessitate targeting palliative care interventions to patients who need them most.1 The “surprise” question (SQ)—“Would you be surprised if this patient died in the next 12 months?”—has emerged as an attractive, simple solution for identifying patients who might benefit from palliative care.2,3 Despite optimism about the potential of the SQ to identify primary care patients who would benefit from palliative care,4 there is no evidence on its performance in this setting.

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