Palliative Prognostic Score (PaP)
Estimates 30-day survival probability in terminally ill patients using clinical and laboratory data
- Highest activation tier
- Recommended
- How it is scored
- Scored in code; a stated value is compared only from the structured summary or a supplied value
- Scoring type
- formula
- Care settings
- Inpatient, Outpatient
When it activates
Scribeable activates a calculator from the encounter. The Palliative Prognostic Score (PaP) can activate when the transcript or pasted chart context documents any of these:
- 30-day survival estimation
- Palliative prognosis assessment
- End-of-life care planning
Inputs the note needs
6 inputs. Each is resolved from the transcript, the pasted chart context and charted labs; at this calculator’s tier a missing input is never requested, and a missing required input keeps the score out of the draft.
| Input | Type | Unit / options | Guidance |
|---|---|---|---|
| Presence of dyspnea (true/false) | symptom | ||
| Presence of anorexia (true/false) | symptom | ||
| Karnofsky Performance Status (10-100) | history | ||
| Clinical prediction of survival in weeks | history | ||
| White blood cell count (x10^9/L) | lab | ||
| Lymphocyte percentage | lab |
Scoring
Dyspnea (+1), anorexia (+1.5). KPS ≥50 (0), 30-40 (0), 10-20 (+2.5). Clinical prediction >12wk (0), 11-12 (+2), 9-10 (+2.5), 7-8 (+2.5), 5-6 (+4.5), 3-4 (+6), 1-2 (+8.5). WBC 4.8-8.5 (0), 8.6-11 (+0.5), >11 (+1.5). Lymph 12-19.9% (+1), <12% (+2.5). Total 0-17.5.
Interpretation
Group A (<5.5): 30-day survival >70%. Group B (5.6-11): 30-day survival 30-70%. Group C (>11): 30-day survival <30%.
Evidence
Sources carried in Scribeable's citation registry for this calculator; guideline version: Pirovano 1999.
- Pirovano M et al. A new palliative prognostic score: a first step for the staging of terminally ill cancer patients (PaP Score)Pirovano et al. (PaP) 1999 · 1999 · link last verified 2026-03-28
How Scribeable handles it in the note
When an encounter activates the Palliative Prognostic Score (PaP) (its highest tier is recommended), Scribeable does not ask you for missing inputs. The score is computed in code from whatever inputs resolve from the transcript, the pasted chart context or charted labs; a computed value is written into the draft only when every required input already resolves.
The score is computed in code from the resolved inputs, not recalled by the language model. A stated Palliative Prognostic Score (PaP) value is compared against the computed one when the draft's structured summary carries it; a disagreement found there is flagged to the second drafting pass, which is instructed to correct the score and its interpretation, unless Scribeable has supplied the computed value to that pass, in which case the value the draft writes is checked against the supplied one and a detected difference is shown beside the note for you to adjudicate rather than silently rewritten.
Classified as a risk score: activated strictly, by a documented trigger, never by a permissive reading of the encounter.
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