Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Simple system predicts mortality of older Americans with 81 percent accuracy

15.02.2006


Information can be gathered in minutes using 12-question form in doctor’s waiting room



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.

The researchers classified participants according to three broad classes of variables: demographics -- specifically, gender and age; illnesses, such as cancer, diabetes, heart disease, and hypertension; and ability to perform activities of daily living, such as washing, dressing, shopping, and managing finances. They then noted who had died by December 31, 2002 and analyzed to what extent the different variables had predicted mortality.

A patient who scores zero points on the index has a predicted four-year mortality of less than one percent. A patient with a score of more than 14 points has a 65 percent chance of dying within four years.

"The fact that we account for different kinds of risk factors, functional as well as disease-related, allows the scale to be accurate over a very wide range of ages, as well as in all kinds of different people," says Lee. "It gives you the flavor of the relative importance of each risk factor. For example, being unable to walk several blocks is as many points off as having heart failure."

Ideally, says Lee, "I see the index being used as part of a standard intake form in the doctor’s office, when the doctor sees the patient for the first time."

Lee cautions that there are many other prognostic indexes, only a few of which have achieved widespread use. As the study notes, however, many are limited to specific populations, focus on single types of risk such as illness or function, or require laboratory testing. Unlike those indexes, Lee says, "this index has the advantage of being applicable to everyone who is seen in a clinic who is older than 50. There aren’t many indexes that are as widely applicable." Co-authors of the study are Karla Lindquist, MS, of SFVAMC and UCSF; Mark R. Segal, PhD, of UCSF; and Kenneth E. Covinksy, MD, MPH, of SFVAMC and UCSF.

Steve Tokar | EurekAlert!
Further information:
http://www.ncire.org
http://www.ucsf.edu/

More articles from Studies and Analyses:

nachricht Rutgers-led innovation could spur faster, cheaper, nano-based manufacturing
14.02.2018 | Rutgers University

nachricht New study from the University of Halle: How climate change alters plant growth
12.01.2018 | Martin-Luther-Universität Halle-Wittenberg

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Attoseconds break into atomic interior

A newly developed laser technology has enabled physicists in the Laboratory for Attosecond Physics (jointly run by LMU Munich and the Max Planck Institute of Quantum Optics) to generate attosecond bursts of high-energy photons of unprecedented intensity. This has made it possible to observe the interaction of multiple photons in a single such pulse with electrons in the inner orbital shell of an atom.

In order to observe the ultrafast electron motion in the inner shells of atoms with short light pulses, the pulses must not only be ultrashort, but very...

Im Focus: Good vibrations feel the force

A group of researchers led by Andrea Cavalleri at the Max Planck Institute for Structure and Dynamics of Matter (MPSD) in Hamburg has demonstrated a new method enabling precise measurements of the interatomic forces that hold crystalline solids together. The paper Probing the Interatomic Potential of Solids by Strong-Field Nonlinear Phononics, published online in Nature, explains how a terahertz-frequency laser pulse can drive very large deformations of the crystal.

By measuring the highly unusual atomic trajectories under extreme electromagnetic transients, the MPSD group could reconstruct how rigid the atomic bonds are...

Im Focus: Developing reliable quantum computers

International research team makes important step on the path to solving certification problems

Quantum computers may one day solve algorithmic problems which even the biggest supercomputers today can’t manage. But how do you test a quantum computer to...

Im Focus: In best circles: First integrated circuit from self-assembled polymer

For the first time, a team of researchers at the Max-Planck Institute (MPI) for Polymer Research in Mainz, Germany, has succeeded in making an integrated circuit (IC) from just a monolayer of a semiconducting polymer via a bottom-up, self-assembly approach.

In the self-assembly process, the semiconducting polymer arranges itself into an ordered monolayer in a transistor. The transistors are binary switches used...

Im Focus: Demonstration of a single molecule piezoelectric effect

Breakthrough provides a new concept of the design of molecular motors, sensors and electricity generators at nanoscale

Researchers from the Institute of Organic Chemistry and Biochemistry of the CAS (IOCB Prague), Institute of Physics of the CAS (IP CAS) and Palacký University...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

2nd International Conference on High Temperature Shape Memory Alloys (HTSMAs)

15.02.2018 | Event News

Aachen DC Grid Summit 2018

13.02.2018 | Event News

How Global Climate Policy Can Learn from the Energy Transition

12.02.2018 | Event News

 
Latest News

Basque researchers turn light upside down

23.02.2018 | Physics and Astronomy

Finnish research group discovers a new immune system regulator

23.02.2018 | Health and Medicine

Attoseconds break into atomic interior

23.02.2018 | Physics and Astronomy

VideoLinks
Science & Research
Overview of more VideoLinks >>>