ABOUT ePROGNOSIS 

The ePrognosis: Cancer Screening app is designed to help clinicians and older adult patients make cancer screening decisions.

The information on ePrognosis is intended as a rough guide to 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.

Please visit www.ePrognosis.org for a comprehensive set of prognostic calculators.

VISIT ePROGNOSIS

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ABOUT CALCULATIONS 

To create the calculators, we used information from older adults collected in two large nationally representative surveys: The National Health Interview Survey and the Health and Retirement Survey.  As part of these surveys, in the late 1990’s, U.S. adults were asked about their health behaviors (e.g., smoking), disease burden (e.g., history of diabetes) and function (e.g., difficulty walking several blocks).  We followed respondents to determine if and when they died.  We used statistical methods to learn which factors were most highly associated with chance of death.

We assigned a point value to the factors most most associated with death.  Factors that were more highly associated with death received a higher point value (e.g., being a current smoker is assigned more points than never having smoked).  We calculated a total point score for each respondent based on the presence or absence of factors associated with death.  We then looked at the chance of death for adults with each point score over 4 to 10 years.  We also calculated total point scores for adults that responded to each of the surveys but whose information was not used to identify factors associated with death.  We wanted to make sure that the point scores were associated with similar chances of death in these adults and they were.

Since we used two different surveys to develop the calculators we initially had two separate calculators.  We combined the information from the two calculators into one calculator (15 questions) for this application to give more robust estimates of chance of death in 10 years.

• Schonberg MA, Davis RB, McCarthy EP, and Marcantonio ER.  Index to perdict 5-year mortality of community dwelling adults aged 65 an older using data from the Nationaly health interview Survey. J Gen Intern Med. 2009; 24(10): 1115 – 1022.
• Cruz, M., Covinsky, K., Widera, E.W., Stijacic – Cenzer, I., & Lee, S.J. (2013). Predicting 10-year mortality for older adults. JAMA, 109(9), 874 – 876.
• Lee SJ, Lindquist K,Segal MR, Covinsky KE. Development and validation of a prognositc index for 4-year mortality in older adults. JAMA. 2006 Feb 15; 295(7): 801 – 808.
• Schonberg MA, Davis RB, McCarthy EP, Marcantonio ER. External validation of an index to predict up to 9-year mortality of community – dwelling adults aged 65 and older. J AM Geriatr Soc. 2011 Aug; 59(8): 1444 – 501.

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ABOUT GERIPAL 

ePrognosis was created by the authors of GeriPal, a Geriatrics and Palliative Care blog. GeriPal (Geriatric and Palliative Care) is a forum of discourse, recent news and research, and freethinking commentary.

Our objectives are:

1. To create an online community of interdisciplinary providers interested in geriatrics or palliative care.
2. To provide an open forum for the exchange of ideas and disruptive commentary that changes clinical practice and health care policy.
3. To change the world.

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