Predicting Prognosis

In yesterday’s post about prognostic indexes reviewed in JAMA, I mentioned in passing that researchers had put all the 16 existing indicators into one online resource, While it’s intended for doctors, it’s freely available to anyone.

Paula Span, editor of the New York Times‘ terrific New Old Age blog didn’t hold back. She pointed her readers directly to In the comments section, some of the readers said they were happy to have this tool, some found it distasteful, and several others said they couldn’t figure out how to use it.

I, too, initially had found it confusing. But since there seems to be a lot of interest, here’s a quick explainer.

First, a screen grab of the site’s home page:

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Diagnosis, Treatment … and Maybe a Prognosis?

(Adrian Clark: Flickr)

(Adrian Clark: Flickr)

Back in the days when modern medicine started, around the turn of the 20th century, the practice of medicine was roughly divided into  thirds: diagnosis, treatment and prognosis.

That’s what Alexander Smith, palliative care expert at the San Francisco VA Hospital, told me in an interview. He attributed the approach to the illustrious William Osler, one of the founding professors of Johns Hopkins Hospital, back in the late 19th century.

But things have changed since Dr. Osler ruled in Baltimore. “Prognosis has really waned,” Smith says. “Now in textbooks, there’s just a few lines. The focus is on diagnosis and treatment.”

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