Korean J Fam Pract. 2017; 7(5): 633-639  https://doi.org/10.21215/kjfp.2017.7.5.633
Validation of Accuracy of the Objective Prognostic Score for Predicting Survival Time and Confirmation of Replaceability of Lactate Dehydrogenase Score to C-reactive Protein
Yongjae Jeong1, Min-Jeong Oh1,2,*, Hyokyoung Cho1, Eojin Kim1
1Department of Family Medicine, Busan Medical Center; 2Department of Family Medicine, Pusan National University Hospital, Busan, Korea
Min-Jeong Oh
Tel: +82-51-607-2179, Fax: +82-51-507-3001
E-mail: elvina1004@hanmail.net
Received: December 23, 2016; Revised: May 31, 2017; Accepted: July 26, 2017; Published online: October 20, 2017.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: The objective prognostic score (OPS) has been suggested as a tool to determine expected survival time in terminally ill cancer patients. We aimed to validate the OPS and determine the ability to replace lactate dehydrogenase (LDH) with C-reactive protein (CRP), by comparing the accuracy of survival time prediction among OPS groups with different LDH scores.
Methods: We reviewed electronic medical records of terminally ill cancer patients who died at a single medical center in Busan, from January 2014 to December 2015. We calculated the OPS for these patients and divided them into 3 additional groups according to the ability to replace the LDH score in the OPS with CRP, 1, or 0. Kaplan-Meier survival analysis was performed to validate the OPS, and the area under the receiver operating characteristic curve (AUROC) was used to compare predictive accuracy in 4 groups.
Results: In all groups, patients with an OPS of more than 3 points showed statistically shorter survival time than others (P〈0.001). There was a decrease in overall accuracy when LDH scores were replaced. The AUROC values in all groups were between 0.7 and 0.9 (moderate accuracy); the receiver operating characteristic curves in 4 groups were not statistically different from each other (P≥0.1427).
Conclusion: The validity of the OPS was reaffirmed in this study. Additional research is needed to confirm the ability to replace LDH with CRP.
Keywords: Prognostic Score; Terminal Cancer; Palliative Care; Survival; L-Lactate Dehydrogenase; C-reactive Protein
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