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Patient-Predicted Life Expectancy Among Ambulatory Patients With Heart Failure

Neil J. Nusbaum, MD
JAMA. 2008;300(18):2116-2117. doi:10.1001/jama.2008.551.
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To the Editor: In the study by Dr Allen and colleagues,1 a patient's prediction of his or her life expectancy seemed to bear a relatively close relationship to that based on the actuarial survival for all individuals of the same age and sex, with only a minimal influence from the fact that they had congestive heart failure. The majority of the patients in the study (76/122, 63%) claimed never to have spoken with their physicians about their prognosis once they developed heart failure. Patient denial of whatever information they did receive may also have played an important role in how some patients coped with their illness,2 particularly for many of those who most heavily overestimated their own survival. Patient fatalism and depression may conversely have contributed to the cases of patient underestimates of their survival, although the psychosocial data in Table 1 suggest that depression was a minor issue in this patient population compared with that seen in another study of patients with congestive heart failure at the same institution.3


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November 12, 2008
Larry A. Allen, MD, MHS; Jonathan E. Yager, MD; G. Michael Felker, MD, MHS
JAMA. 2008;300(18):2116-2117. doi:10.1001/jama.2008.552.
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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.
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For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
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