# 030 Prognostication, 2nd ed


Medical College of Wisconsin (EPERC)


Intro:  Physicians tend to be overly optimistic when dealing with prognosis. A study by Christakis illustrates this point (1). He asked 343 physicians to provide survival estimates for 468 terminally ill patients at the time of hospice referral. Only 20% of predictions were accurate (as defined as within 33% of actual survival). Overall, doctors overestimated by a factor of 5.3! Every type of doctor tended to overestimate, although the more experienced physicians had less error. Inaccurate predictions were given for all types of patients, including cancer patients and those with chronic non-malignant diseases. Interestingly, as the duration of the physician patient relationship increased, prognostic accuracy decreased. In other words, the longer a doctor knew his/her patient, the less likely he/she was to correctly predict prognosis.


August 2005; 30.

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Eric J. Warm M.D.

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