在以患者为中心的照护模式中，早期姑息照护（Early Palliative Care，EPC）的转介取决于预后和照护需求的复杂程度。 PALCOM量表是一种五个维度的多维评估工具，旨在确定癌症患者姑息照护需求的复杂程度。本研究旨在验证PALCOM量表。我们开展了一项前瞻性队列研究，比较了PALCOM量表和专家经验评估（EA）对姑息照护需求复杂性的评估。EA需要根据患者的复杂性进行分类，考虑到中高级别需要专家EPC团队的优先关注，而低级别可以由非专家团队管理。多维变量系统收集在电子报告表中，并按照复杂性水平和评分系统（PALCOM量表与EA）进行分层。分析了两个评分系统之间的相关级别（Kendall's tau检验）和准确度测试（F1分数）。使用ROC曲线分析确定PALCOM量表的预测能力。共纳入了283例晚期癌症患者。 EA和PALCOM量表的复杂性级别频率没有显着差异（低级22.3-23.7％；中级57.2-59.0％；高级20.5-17.3％）。在两个评分系统的高复杂性级别中，高病症负担、剧烈疼痛、功能障碍、社会家族风险、存在/精神问题、6个月死亡率和住院死亡率的患病率明显较高（p < 0.001）。比较分析显示两个评分系统之间有很高的相关性和准确性（Kendall's tau检验0.81，F1分数0.84）。ROC分析的曲线下面积证实了PALCOM量表对高和低复杂性的预测能力，分别为0.907和0.902。在以患者为中心的照护模式中，确定复杂性是适当转介并与EPC团队共同协同管理的关键。 PALCOM量表是确定姑息照护需求复杂程度的高精度工具。

In a patient-centred model of care, referral to early palliative care (EPC) depends on both the prognosis and the complexity of care needs. The PALCOM scale is a 5-domain multidimensional assessment tool developed to identify the level of complexity of palliative care needs of cancer patients. The aim of this study was to validate the PALCOM scale.We conducted a prospective cohort study of cancer patients to compare the PALCOM scale and expert empirical assessment (EA) of the complexity of palliative care needs. The EA had to categorise patients according to their complexity, considering that medium to high levels required priority attention from specialist EPC teams, while those with low levels could be managed by non-specialist teams. Systematically collected multidimensional variables were recorded in an electronic report form and stratified by level of complexity and rating system (PALCOM scale versus EA). The correlation rank (Kendall's tau test) and accuracy test (F1-score) between the two rating systems were analysed. ROC curve analysis was used to determine the predictive power of the PALCOM scale.A total of 283 advanced cancer patients were included. There were no significant differences in the frequency of the levels of complexity between the EA and the PALCOM scale (low 22.3-23.7%; medium 57.2-59.0%; high 20.5-17.3%). The prevalence of high symptom burden, severe pain, functional impairment, socio-familial risk, existential/spiritual problems, 6-month mortality and in-hospital death was significantly higher (p < 0.001) at the high complexity levels in both scoring systems. Comparative analysis showed a high correlation rank and accuracy between the two scoring systems (Kendall's tau test 0.81, F1 score 0.84). The predictive ability of the PALCOM scale was confirmed by an area under the curve in the ROC analysis of 0.907 for high and 0.902 for low complexity.In a patient-centred care model, the identification of complexity is a key point to appropriate referral and management of shared care with EPC teams. The PALCOM scale is a high precision tool for determining the level of complexity of palliative care needs.