Table 2 Item selection

 Surprise question 12 months

4.1 ± 1.4; n = 20

 Surprise question 6 months

5.0 ± 0.0; n = 3

 Surprise question months, weeks or days

4.2 ± 0.8; n = 5

 PC required by healthcare professional

3.2 ± 1.8; n = 6

4.3 ± 1.0; n = 7

 PC required implicitly or explicitly by patients or relatives

3.5 ± 1.3; n = 19

 PC required by patients/relatives

3.3 ± 1.4; n = 6

 Advanced illness, unstable symptoms

3.8 ± 1.6; n = 5

 Advanced illness and/or diminishing response to aetiological treatments

4.3 ± 0.5; n = 8

 Disease that cannot be treated, vital prognosis is underway

4.0 ± 1.3; n = 16

 Decreased response to treatment

1.7 ± 0.6; n = 3

 At least one disturbing symptom

2.6 ± 0.9; n = 11

4.1 ± 0.8; n = 11

 Decrease in general condition

3.2 ± 1.3; n = 6

4.8 ± 0.5; n = 4

 Poor or deteriorating performance status

2.6 ± 0.8; n = 7

3.8 ± 0.8; n = 9

 General functional decline

1.9 ± 0.8; n = 8

5.0 ± 0.0; n = 8

 Functional markers of decline

2.5 ± 0.6; n = 4

 Dependency on others for most care needs

n = 0

 Nutritional markers of decline

1.8 ± 0.7; n = 8

4.0 ± 0.6; n = 4

 Significant weight loss

2.0 ± 0.8; n = 4

 Interruption of any vital support measures

2.7 ± 0.8; n = 6

4.0 ± 0.8; n = 11

 Other markers of severity and extreme fragility

2.0 ± 1.0; n = 12

3.7 ± 0.7; n = 9

 Sentinel events

n = 0

  ≥ 2 unscheduled hospitalizations

1.8 ± 1.0; n = 9

3.9 ± 0.8; n = 9

  ≥ 2 concomitant diseases

n = 0

 Significant co-morbidity

2.0 ± 1.1; n = 7

3.7 ± 0.9; n = 9

 Emotional distress

1.8 ± 0.7; n = 8

3.7 ± 0.8; n = 6

 Specific population

4.1 ± 1.1; n = 11

3.6 ± 1.6; n = 8

 Rapidly evolving illness

3.2 ± 1.8; n = 5

3.8 ± 1.7; n = 8

 Need for complex and intense continuing care

3.0 ± 1.5; n = 12

2.3 ± 1.0; n = 9

 Persistent and distressing symptoms

4.4 ± 0.6; n = 27

  ≥ 3 symptoms > 5 on ESAS

3.8 ± 1.5; n = 8

3.6 ± 1.5; n = 10

 Uncontrolled pain

3.2 ± 1.2; n = 9

4.3 ± 0.9; n = 16

 Difficulties in assessing symptoms

3.8 ± 0.9; n = 18

3.5 ± 1.1; n = 15

 Severe psychological and/or existential distress

2.6 ± 1.0; n = 18

2.6 ± 1.2; n = 17

 Request for assisted suicide or euthanasia

1.4 ± 1.1; n = 8

2.2 ± 1.5; n = 6

 Psychosocial distress patient and/or relatives

2.5 ± 0.9; n = 17

3.0 ± 1.1; n = 11

 Difficulties in integrating information about the  disease and/or prognosis

1.0 ± 0.0; n = 1

 Lack or insufficient support from relatives

2.0 ± 1.0; n = 3

 Social vulnerability

2.0 ± 0.0; n = 1

 Accompanying the patient is difficult

1.4 ± 0.8; n = 7

 Difficulties in communicating about therapeutic/care objectives

1.8 ± 0.4; n = 6

2.0 ± 1.4; n = 8

 Significant disagreement, uncertainty or conflict

2.5 ± 1.5; n = 21

2.8 ± 1.4; n = 22

 Need for support and/or second opinion for current decision-making

1.9 ± 0.8; n = 9

 Difficulties in writing advanced directives

n = 0

 Specialised PC team required by healthcare professional

3.6 ± 1.3; n = 5

 Palliative sedation envisaged

2.6 ± 1.3; n = 14

 Need for respite for the relatives

1.3 ± 0.6; n = 3