Researchers at the San Francisco VA Medical Center have created an index that is 81 percent accurate in predicting the likelihood of death within four years for people 50 and older.
The index, which weighs different mortality risk factors according to a simple point system, is potentially useful to health care providers, policymakers, and researchers, say the study authors.
The information can be obtained using a 12-question form that "could be completed in a few minutes by a patient or medical office receptionist," according to lead author Sei J. Lee, MD, a geriatric specialist at SFVAMC.
"There's a real need for this kind of prognostic index, for several reasons," says Lee, who is also a research fellow in the Division of Geriatrics at the University of California, San Francisco.
For patients and caregivers, predicting near-term likelihood of death is useful when making decisions about medical tests and clinical care, he says. "For example, is it worth it to order a Pap smear or colonoscopy for a particular patient? Those sorts of screening interventions generally don't help patients until five to eight years after they are given. Doctors need to get a sense of who will survive long enough to benefit."
The study appears in the February 15, 2006 issue of The Journal of the American Medical Association (JAMA).
According to the study authors, policymakers can also use such data when comparing the quality of care between different health care organizations, such as hospitals, and insurance plans. "Accurate risk-adjustment levels the playing field by accounting for differences in health status" of different organizations' patient populations," the paper states.
Finally, prognostic information is helpful for researchers conducting observational studies of patients, notes Lee. "You can use the data to adjust for differences between two groups," he says. "If one group is healthier, this index can capture how much healthier they are. This can help researchers isolate the effect of a treatment from the baseline differences between the two groups."
To create the index, the researchers looked at data collected between 1998 and 2002 from 19,710 community-dwelling adults aged 50 and older who participated in the nationwide Health and Retirement Survey (HRS), a longitudinal study of health, retirement, and aging sponsored by the National Institute on Aging. Participants in the HRS were chosen as a representative sample of all adults in the contiguous United States older than 50 years.