Screening Tools for the Early Identification of Palliative Care Needs in Patients with Advanced Chronic Conditions: An Updated Systematic Review

Abstract

<b>Background/Objectives</b>: Earlier initiation of palliative care improves clinical outcomes, including better symptom relief, enhanced quality of life, and decreased use of healthcare resources in advanced disease. This systematic review aimed to identify and critically appraise existing tools, both conventionally developed and based on artificial intelligence, designed to identify patients eligible for early palliative care interventions. <b>Methods</b>: Six electronic databases were examined for primary research studies published between 2000 and 2025. Studies that described or evaluated screening instruments developed to support the early identification of adult patients with palliative care needs underwent dual reviewer screening and data extraction. <b>Results</b>: A total of 35 studies were included. Of these, 13 reported the development of screening tools and 22 focused on the external validation of these instruments. Nine tools were developed using traditional methods, and four instruments were created using artificial intelligence techniques. Significant heterogeneity was observed in tool design and target populations. Most screening tools used death prediction as a proxy, with limited integration of psychological and spiritual dimensions. External validation studies primarily focused on predicting mortality. Overall, all the tools showed moderate predictive ability. <b>Conclusions</b>: The ability of current screening tools to identify patients with advanced diseases who are likely to have palliative care needs remains limited. Further research is needed to develop standardized screening processes that address not only mortality prediction but also disease trajectory and functional decline.

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