University of California, San Francisco, School of Medicine
Although many geriatric prognostic indices have been published, they may be difficult for busy clinicians to remember and use. The goal of ePrognosis (www.eprognosis.org) is to be a repository of validated geriatric prognostic indices for application in clinical and educational settings. The prognostic indices used in ePrognosis are derived from a systematic review of the literature, published by our group in JAMA January 11, 2011. ePrognosis offers a tutorial on how to use prognositic indicators in older adults. It also helps clinicians sort through quality issues of each index through it's use of a novel sorting algorithm. This algorithm uses set criteria to sort the indices by accuracy, generalizability, bias, usability, and clinical efficacy.
- Describe 4 steps needed to apply prognositic indices to an individual patient encounter.
- Identify the 5 factors that influence how one selects the best indices for an indivial patient (prediction accuracy, model generalizability, usability, clinical efficacy, and time-frame)
- Apply prognostic indices to at least one common clinical scenario for older adults in which the consideration of prognosis may improve decision making.
The indices in ePrognosis (www.ePrognosis.org) are designed for older adults who do not have a dominant terminal illness. For patients with a dominant terminal illness, such as advanced dementia, cancer, or heart failure, prognostic indices specifically designed for those purposes should be used (see the Links tab in ePrognosis).
The information on ePrognosis is intended as a rough guide to educate and inform clinicians about possible mortality outcomes. It is not intended to be the only basis for making care decisions, nor is it intended to be a definitive means of prognostication. Clinicians should keep in mind that every patient is an individual, and that many factors beyond those used in these indices may influence a patient's prognosis.