Prognosis

Prognosis

Prognosis (Greek πρόγνωση - literally fore-knowing, foreseeing) is a medical term to describe the likely outcome of an illness.

When applied to large statistical populations, prognostic estimates can be very accurate: for example the statement "45% of patients with severe septic shock will die within 28 days" can be made with some confidence, because previous research found that this proportion of patients died. However, it is much harder to translate this into a prognosis for an individual patient: additional information is needed to determine whether a patient belongs to the 45% who will succumb, or to the 55% who survive.[1]

A complete prognosis includes expected time, function, and a description of the disease course such as progressive decline, intermittent crisis, or sudden, unpredictable crisis.

Contents

Methodology

Disease and prognostic indicators

Prognostic scoring is also used for other cancer outcome predictions. A Manchester score is an indicator of prognosis in small cell lung cancer. In Non-Hodgkin lymphoma, physicians have developed the International Prognostic Index to predict patient outcome.

Other medical areas where prognostic indicators are used is in Drug-Induced Liver Injury (DILI) (Hy's law) and use of an exercise stress test as a prognostic indicator after myocardial infarction.

End of life

Medical studies have demonstrated that most doctors are overly optimistic when giving prognostic information, that is, they tend to overstate how long the patient might live. For patients who are critically ill, particularly those in an intensive care unit, there are numerical prognostic scoring systems that are more accurate. The most famous of these is the APACHE II scale. However, this scale is most accurate in the seven days prior to a patient's predicted death.

Knowing the prognosis helps determine whether it makes more sense to attempt certain treatments or to withhold them, and thus plays an important role in end-of-life decisions.

Estimator

Estimators that are commonly used to describe prognoses include:

  • Progression-free survival - the length of time during and after medication or treatment during which the disease being treated (usually cancer) does not get worse.
  • Survival rate - indicating the percentage of people in a study or treatment group who are alive for a given period of time after diagnosis.
  • Survival time - the remaining duration of life. If not else specified, it is generally starting from the time of diagnosis.

History

For the 19th century physicians, particularly the French school, the main aim of medicine was not to cure disease, but rather to give a medical diagnosis and achieve a satisfying prognosis of the patient's chances. Only several decades later did the focus of efforts in Western medicine shift to curing disease.

See also

References

  1. ^ Gould, SJ, http://www.prognosis.org/what_does_it_mean.php, retrieved 2009-01-07 

External links


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  • prognosis — 1650s, forecast of the probable course of a disease, from L.L. prognosis, from Gk. prognosis foreknowledge, from progignoskein come to know beforehand, from pro before (see PRO (Cf. pro )) + gignoskein come to know (see GNOSTIC (Cf. gn …   Etymology dictionary

  • Prognosis — Prog*no sis, n. [L., fr. Gr. ?, fr. ? to know beforehand; ? before + ? to know. See {Know}.] (Med.) The act or art of foretelling the course and termination of a disease; also, the outlook afforded by this act of judgment; as, the prognosis of… …   The Collaborative International Dictionary of English

  • prognosis — [präg nō′sis] n. pl. prognoses [präg nō′sēz΄] [LL < Gr prognōsis < progignōskein < pro , before (see PRO 1) + gignōskein, to KNOW] a forecast or forecasting; esp., a prediction of the probable course of a disease in an individual and the …   English World dictionary

  • prognosis — pronóstico de la evolución de un ataque o de una enfermedad. Diccionario ilustrado de Términos Médicos.. Alvaro Galiano. 2010 …   Diccionario médico

  • prognosis — I noun conjecture, estimate, foreboding, forecast, foreknowledge, foresight, foretelling, guess, opinion, preannouncement, prediction, prefiguration, prefigurement, premonition, prenotice, presage, presagement, presumption, prognostication,… …   Law dictionary

  • prognosis — *diagnosis …   New Dictionary of Synonyms

  • prognosis — [n] forecast cast, diagnosis, expectation, foretelling, guess, prediction, prevision, prognostication, projection, prophecy, speculation, surmise; concepts 274,689 …   New thesaurus

  • prognosis — (Del gr. πρόγνωσις). f. Conocimiento anticipado de algún suceso. Se usa comúnmente hablando de la previsión meteorológica del tiempo …   Diccionario de la lengua española

  • prognosis — ► NOUN (pl. prognoses) ▪ a forecast, especially of the likely course of a disease or ailment. ORIGIN Greek, from pro before + gign skein know …   English terms dictionary

  • prognosis — (Del gr. prognosis.) ► sustantivo femenino Conocimiento anticipado de una cosa, en especial del tiempo meteorológico. IRREG. plural prognosis * * * prognosis (del gr. «prógnōsis») f. *Conocimiento anticipado de un suceso. ⊚ Se aplica… …   Enciclopedia Universal

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