RT Journal
A1 Smith AK, Yourman LC, Lee SJ
T1 PRognostic models for older adults—reply
JF JAMA
JO JAMA
YR 2012
FD May 9
VO 307
IS 18
SP 1911
OP 1912
DO 10.1001/jama.2012.3615
UL http://dx.doi.org/10.1001/jama.2012.3615
AB 
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.