• Fabienne Teike Lüthi, Mathieu Bernard, Katia Vanderlinden, Pierluigi Ballabeni, Claudia Gamondi, Anne-Sylvie Ramelet, and Gian Domenico Borasio.
• Palliative and Supportive Care Service, Lausanne University Hospital and University of Lausanne (F.T.L., M.B., K.V., C.G., G.D.B.), Lausanne, Switzerland; Institute of Higher Education and Research in Healthcare, University of Lausanne and Lausanne University Hospital (F.T.L., P.B., A.S.R.), Lausanne, Switzerland. Electronic address: fabienne.teike-luethi@chuv.ch.
• J Pain Symptom Manage. 2021 Sep 1; 62 (3): e75-e84.

ContextTo improve access to palliative care, identification of patients in need of general or specialized palliative care is necessary. To our knowledge, no available identification instrument makes this distinction. ID-PALL is a screening instrument developed to differentiate between these patient groups.ObjectiveTo assess the structural and criterion validity and the inter-rater agreement of ID-PALL.MethodsIn this multicenter, prospective, cross-sectional study, nurses and physicians assessed medical patients hospitalized for 2 to 5 days in two tertiary hospitals in Switzerland using ID-PALL. For the criterion validity, these assessments were compared to a clinical gold standard evaluation performed by palliative care specialists. Structural validity, internal consistency and inter-rater agreement were assessed.Results2232 patients were assessed between January and December 2018, 97% by nurses and 50% by physicians. The variances for ID-PALL G and S are explained by two factors, the first one explaining most of the variance in both cases. For ID-PALL G, sensitivity ranged between 0.80 and 0.87 and specificity between 0.56 and 0.59. ID-PALL S sensitivity ranged between 0.82 and 0.94, and specificity between 0.35 and 0.64. A cut-off value of 1 delivered the optimal values for patient identification. Cronbach's alpha was 0.78 for ID-PALL G and 0.67 for ID-PALL S. The agreement rate between nurses and physicians was 71.5% for ID-PALL G and 64.6% for ID-PALL S.ConclusionID-PALL is a promising screening instrument allowing the early identification of patients in need of general or specialized palliative care. It can be used by nurses and physicians without a specialized palliative care training. Further testing of the finalized clinical version appears warranted.Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

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