Although many geriatric prognostic indices have been published, they may be difficult for busy clinicians to remember and use. Our goal is to be a repository of published geriatric prognostic indices where clinicians can go to obtain evidence-based information on patients’ prognosis.
To locate prognostic indices, we conducted a systematic review of the literature, published in JAMA January 11, 2011. Users should refer to this systematic review for detailed information on the accuracy, generalizability, potential for bias, and usability of these indices.
These indices are designed for older adults who do not have a dominant terminal illness. For patients with a dominant terminal illness, such as advanced dementia, cancer, or heart failure, prognostic indices specifically designed for those purposes should be used (see the Links tab).
The information on ePrognosis is intended as a rough guide to inform clinicians about possible mortality outcomes. It is not intended to be the only basis for making care decisions, nor is it intended to be a definitive means of prognostication. Clinicians should keep in mind that every patient is an individual, and that many factors beyond those used in these indices may influence a patient's prognosis.
The sorting algorithm on the front page uses a balloon chart. We were inspired by the blog informationisbeautiful.
About the Authors
Sei Lee, MD MAS Is an Assistant Professor in the Division of Geriatrics at UCSF. When not running after his 3 kids, he’s wondering why the same mountain biking trails are steeper now than 4 years ago.
Contact: Sei.lee@ucsf.edu
Alex Smith, MD MS MPHIs an Assistant Professor in the Division of Geriatrics at UCSF. Alex co-founded GeriPal, a geriatrics and palliative care blog, with Eric Widera. When not running after his 2 kids, he is trying to get his first serve percentage above 50%.
Contact: aksmith@ucsf.edu, Twitter: @alexsmithMD
Is an Assistant Professor in the Division of Geriatrics at UCSF. Eric co-founded GeriPal, a geriatrics and palliative care blog, with Alex Smith. When not running after his 1 kid, he is searching for the perfect scoop of ice cream.
Twitter: @ewidera
Lindsey Yourman, MDIs an intern at Scripps Mercy Hospital in San Diego. She was a 4th year medical student at UCSF and Research Fellow for the Division of Geriatrics at the time that she completed the study. She obtained her BA in Psychology from Harvard. Inspired by her grandparents and eprognosis mentors, she hopes to become a geriatrician.
Contact: yourman@post.harvard.edu
Mara Schonberg, MD MPH Is an Assistant Professor in the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center. Mara is very lucky to have had 3 grandparents, in addition to her patients, teach her the importance of prognosticating when deciding on medical interventions.
Contact: mschonbe@bidmc.harvard.edu
Cyrus Ahalt, MPPIs a Research Associate for the Division of Geriatrics at UCSF. There, he supports three principal investigators, each concerned with elder care and the importance of prognosis in determining care.
Contact: cyrus.ahalt@ucsf.edu
Media Coverage of ePrognosis
- New York Times: The New Old Age "Figuring the Odds." 5/2/2011
- New York Times: The New Old Age "A Lifespan Predictor: The Readers have Spoken." 5/13/2011
- MSNBC with Thomas Roberts 5/16/2011
- GeriPal "A New Tool for Estimating Prognosis" 5/2/2011
- New York Times: The New Old Age "The Unspoken Diagnosis: Old Age" 12/29/11
- New York Times "Interactive Tools to Assess the Likelihood of Death." 1/10/12
- New York Times: The New Old Age "How Long Until The End?" 1/10/12
- GeriPal "Prognostic Indices for Older Adults: Useful or Waste of Time?" 1/10/12
- KQED Blog "Diagnosis, Treatment, and Maybe a Prognosis!" 1/10/12
- Fox News "Doctors Should Not Rely on Computers to Diagnose Patients 1/11/12
- The Incidental Economist "Assessing Patient Prognosis (ePrognosis)" 1/11/12
- The Daily Beast "Online Mortality Calculator Could Change Health Care and Our Views on Death" 1/15/12
- Pallimed "The Prognostic Frame of Healthcare for Older Adults" 1/16/12
- KMJ News Fresno 1/17/12
- Hartford Foundation's health AGEnda blog "Should Life Expectancy Affect Treatment" 1/17/12
- The Hastings Center Bioethics Forum "Beware the Ides of March" 1/18/12
- New York Times "Why Doctors Can't Predict How Long A Patient Will Live" 1/19/12
- USA Today "Do Seniors Really Want to Know Life Expectancy?" 2/19/12
- Blog.AARP.org "The Takeaway: Patients Flock to Life Expectancy Website ePrognosis" 2/21/12
- KALW (NPR) "Can Knowing When You Die Help You Live?" 3/1/12