Surprise Question for End-of-Life Prognosis
Single-question prognostic screening tool: 'Would you be surprised if this patient were to die in the next 12 months?' A 'no' answer identifies patients who may benefit from proactive palliative and supportive care planning. Simple, validated in multiple clinical settings.
Score interpretation
Yes — would be surprised: lower 12-month mortality risk in this patient's current clinical state
→ Continue standard care; reassess at next clinical review; document response in clinical notes; consider if patient has any unmet supportive care needs; review annually or with significant change in condition
No — would NOT be surprised: patient may die within 12 months
→ Initiate supportive/palliative care referral; Gold Standards Framework (GSF) register; goals of care discussion with patient and family; DNACPR consideration; advance care plan (ACP); preferred place of care/death; review medications (deprescribing); ensure out-of-hours palliative care plan in place; consider specialist palliative care team involvement; document clearly in records
Interpretation bands for the Surprise Question. Apply clinical judgement and local guidance.
References
- Moss AH et al. Prognostic significance of the 'surprise' question in cancer patients. J Palliat Med. 2010;13(7):837–840.
- Moroni M et al. The 'surprise' question in advanced cancer patients: a prospective study among general practitioners. Palliat Med. 2014;28(7):959–964.
Related
Curated clinical cross-links plus same-class fallbacks.
- Gaviscon Advance (Alginate Preparation) · Alginate / Antacid Combination
- Sodium alginate with calcium carbonate and sodium bicarbonate · Reflux suppressant (alginate raft + antacid)
- Alginic Acid · Antacid / Alginate (GORD Treatment)
- Factor IX Concentrate · Coagulation Factor Replacement — Haemophilia B
- Sodium hyaluronate · Ocular lubricant (hyaluronic acid)
- Medical-Grade Honey (Manuka) · Topical Wound Care Agent
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.