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Editorial |

Prognostic Indices in Clinical Practice

Donald A. Redelmeier, MD; Andrew J. Lustig, MD
JAMA. 2001;285(23):3024-3025. doi:10.1001/jama.285.23.3024.
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Extract

Prognostic indices are used extensively in clinical research and health service quality reviews to adjust for patients' severity of illness. Given their ubiquitous use in clinical studies, it seems surprising that prognostic indices are rarely used in clinical practice. Such disregard seems to persist even if a prognostic index addresses an important outcome, is derived by rigorous methods, and appears in a prestigious journal. Consider the article by Walter et al1 in this issue of THE JOURNAL that reports that older patients hospitalized on a general medical service have about a one-third risk of dying in the year following discharge. The 6 characteristics that can be used to predict a patient's specific risk are male sex, dependence in activities of daily living, cancer, heart failure, renal insufficiency, and hypoalbuminemia.

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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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