Prognosis

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Prognosis is a medical term to describe the likely outcome of an illness. When applied to large populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because previous research found that this proportion of patients died. However, it is much more difficult to translate this into a prognosis for an individual patient: additional information is needed to determine whether a patient belongs to the 45% who will succumb, or to the 55% who survive.^[1] A complete prognosis includes expected time, function, and a description of the disease course such as progressive decline, intermittent crisis, or sudden, unpredictable crisis.

Contents 1 Methodology 1.1 Disease and prognostic indicators 1.2 End of life 2 History 3 See also 4 References 5 External links

[edit] Methodology

[edit] Disease and prognostic indicators

Two areas where this type of prognosis prediction, or the use of prognostic indicators, is with Hodgkin's lymphoma and Non-Hodgkin lymphoma.^{[clarification needed]} Specifically with Non-Hodgkin lymphoma, physicians have developed the International Prognostic Index to predict patient outcome.

Prognostic scoring is also used for other cancer outcome predictions. A Manchester score is an indicator of prognosis in small cell lung cancer.

Other medical areas prognostic indicators are used is in Drug-Induced Liver Injury (DILI) (Hy's Law) and use of an exercise stress test as a prognostic indicator after myocardial infarction.

[edit] End of life

Large areas of medicine are still missing statistical figures on the exact prognosis - in these matters the physician's previous experiences largely guides pronouncements in this matter. Medical studies have demonstrated that most doctors are overly optimistic when giving prognostic information, that is, they tend to overstate how long the patient might live. For patients who are critically ill, particularly those in an intensive care unit, there are numerical prognostic scoring systems that are more accurate. The most famous of these is the APACHE II scale. However, this scale is most accurate in the seven days prior to a patient's predicted death.

Knowing the prognosis helps determine whether it makes more sense to attempt certain treatments or to withhold them, and thus plays an important role in end-of-life decisions.

[edit] History

Medieval European physicians would sometimes use numerology to calculate a prognosis, using the Sphere of Petosiris.^{[citation needed]}

For the great 19th century physicians, particularly the French school, the main aim of medicine was not to cure disease, but rather to diagnose it and achieve a satisfying prognosis of the patient's chances. Only several decades later did the focus of efforts in Western medicine shift to curing disease.

[edit] See also

• Diagnosis
• Nocebo
• Optimism bias
• Placebo (origins of technical term)
• Prognostics
• Reference class forecasting
• Sign (medicine)
• Symptom
• Thought experiment

[edit] References

[edit] External links

• Computer models at prognosis.org
• PrognostiCheck detects changes in tissue electrical properties and is a reliable and objective prognostic indicator in several chronic conditions.