0
Letters |

Prognostic Models for Older Adults—Reply

Alexander K. Smith, MD, MS, MPH; Lindsey C. Yourman, MD; Sei J. Lee, MD
JAMA. 2012;307(18):1911-1912. doi:10.1001/jama.2012.3615.
Text Size: A A A
Published online

Extract

In Reply: In response to Dr Stern, we agree that estimating life expectancy from life tables has utility.1 Furthermore, life expectancy may be more interpretable to clinicians and patients than mortality risk.2 Using multiple sources (both prognostic models and life tables) may improve the accuracy of the prognostic estimate. As described by Walter and Covinsky,3 life expectancy estimates generated by US census data are 1 method of obtaining this information. However, clinicians must first decide if their patient falls in the upper 25th percentile, middle 50th percentile, or lowest 25th percentile of health for their age group. Prognostic indices may assist with this determination. Keeler et al4 refined the life table method to incorporate mobility-disability and activities of daily living. Unlike the prognostic models in our study, however, this method has not been subject to validation. The prognostic model and life table strategies should be tested and compared in diverse clinical settings to evaluate their accuracy, acceptability, and impact on clinician behavior and patient outcomes.

Topics

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

May 9, 2012
Ezra Gabbay, MD, MS; David M. Kent, MD, MS
JAMA. 2012;307(18):1911-1912. doi:10.1001/jama.2012.3568.
CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Jobs
brightcove.createExperiences();