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Created page with "<p><strong>ognosis</strong> (Greek πρόγνωση - literally fore-knowing, foreseeing) is a medical term to describe the likely outcome of an illness...."
<p><strong>ognosis</strong> (Greek πρόγνωση - literally fore-knowing, foreseeing) is a medical term to describe the likely outcome of an illness. When applied to large 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.<sup id="cite_ref-0" class="reference"><font size="2">[1]</font></sup> A complete prognosis includes expected time, function, and a description of the disease course such as progressive decline, intermittent crisis, or sudden, unpredictable crisis.</p>
<h2><span id="Methodology" class="mw-headline">Methodology</span></h2>
<h3><span id="Disease_and_prognostic_indicators" class="mw-headline">Disease and prognostic indicators</span></h3>
<p>Two areas where this type of prognosis prediction, or the use of <i>prognostic indicators</i>, is with Hodgkin's lymphoma and Non-Hodgkin lymphoma.<sup style="white-space: nowrap" class="noprint Inline-Template" title="The text in the vicinity of this tag needs clarification or removal of jargon from August 2009"><font size="2">[<i>clarification needed</i>]</font></sup> Specifically with Non-Hodgkin lymphoma, physicians have developed the International Prognostic Index to predict patient outcome.</p>
<p>Prognostic scoring is also used for other cancer outcome predictions. A Manchester score is an indicator of prognosis in small cell lung cancer.</p>
<p>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.</p>
<h3><span id="End_of_life" class="mw-headline">End of life</span></h3>
<p>Large areas of medicine are still missing statistical figures on the exact prognosis - in these matters the physician's previous experiences largely guides pronouncements in this matter. 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.</p>
<p>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.</p>
<h2><span id="Estimator" class="mw-headline">Estimator</span></h2>
<p>Estimators that are commonly used to describe prognoses include:</p>
<ul>
<li><i>Progression-free survival</i> - the length of time during and after medication or treatment during which the disease being treated (usually cancer) does not get worse.</li>
<li><i>Survival rate</i> - indicating the percentage of people in a study or treatment group who are alive for a given period of time after diagnosis.</li>
<li><i>Survival time</i> - the remaining duration of life. If not else specified, it is generally starting from the time of diagnosis.</li>
</ul>
<h2><span id="History" class="mw-headline">History</span></h2>
<p>Medieval European physicians would sometimes use numerology to calculate a prognosis, using the Sphere of Petosiris.<sup style="white-space: nowrap" class="Template-Fact" title="This claim needs references to reliable sources from June 2009"><font size="2">[<i>citation needed</i>]</font></sup></p>
<p>For the great 19th century physicians, particularly the French school, the main aim of medicine was not to cure disease, but rather to diagnose it and achieve a satisfying <i>prognosis</i> of the patient's chances. Only several decades later did the focus of efforts in Western medicine shift to curing disease.</p>
<h2><span id="See_also" class="mw-headline">See also</span></h2>
<ul>
<li>Diagnosis</li>
<li><a href="/wiki/Nocebo"><font color="#0645ad">Nocebo</font></a></li>
<li><a href="/wiki/Optimism_bias"><font color="#0645ad">Optimism bias</font></a></li>
<li><a class="mw-redirect" title="Placebo (origins of technical term)" href="/wiki/Placebo_(origins_of_technical_term)"><font color="#0645ad">Placebo (origins of technical term)</font></a></li>
<li><a href="/wiki/Prognostics"><font color="#0645ad">Prognostics</font></a></li>
<li><a href="/wiki/Reference_class_forecasting"><font color="#0645ad">Reference class forecasting</font></a></li>
<li><a class="mw-redirect" title="Sign (medicine)" href="/wiki/Sign_(medicine)"><font color="#0645ad">Sign (medicine)</font></a></li>
<li><a href="/wiki/Symptom"><font color="#0645ad">Symptom</font></a></li>
<li><a href="/wiki/Thought_experiment"><font color="#0645ad">Thought experiment</font></a></li>
</ul>
<h2><span id="References" class="mw-headline">References</span></h2>
<div class="reflist">
<div class="references">
<ol>
<li id="cite_note-0"><b><a href="#cite_ref-0"><font color="#0645ad">^</font></a></b> <span id="CITEREFGould.2C_SJ" class="citation">Gould, SJ, <a class="external free" rel="nofollow" href="http://www.prognosis.org/what_does_it_mean.php"><font color="#3366bb">http://www.prognosis.org/what_does_it_mean.php</font></a><span class="reference-accessdate">, retrieved 2009-01-07</span></span><span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=&rft.aulast=Gould%2C+SJ&rft.au=Gould%2C+SJ&rft_id=http%3A%2F%2Fwww.prognosis.org%2Fwhat_does_it_mean.php&rfr_id=info:sid/en.wikipedia.org:Prognosis"><span style="display: none"> </span></span></li>
</ol>
</div>
</div>
<h2><span id="External_links" class="mw-headline">External links</span></h2>
<ul>
<li><a class="external text" rel="nofollow" href="http://www.prognosis.org"><font color="#3366bb">Computer models at prognosis.org</font></a></li>
<li><a class="external text" rel="nofollow" href="http://www.ipgdx.com/PrognostiCheck_Overview.html"><font color="#3366bb">PrognostiCheck detects changes in tissue electrical properties and is a reliable and objective prognostic indicator in several chronic conditions.</font></a></li>
</ul>
<h2><span id="Methodology" class="mw-headline">Methodology</span></h2>
<h3><span id="Disease_and_prognostic_indicators" class="mw-headline">Disease and prognostic indicators</span></h3>
<p>Two areas where this type of prognosis prediction, or the use of <i>prognostic indicators</i>, is with Hodgkin's lymphoma and Non-Hodgkin lymphoma.<sup style="white-space: nowrap" class="noprint Inline-Template" title="The text in the vicinity of this tag needs clarification or removal of jargon from August 2009"><font size="2">[<i>clarification needed</i>]</font></sup> Specifically with Non-Hodgkin lymphoma, physicians have developed the International Prognostic Index to predict patient outcome.</p>
<p>Prognostic scoring is also used for other cancer outcome predictions. A Manchester score is an indicator of prognosis in small cell lung cancer.</p>
<p>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.</p>
<h3><span id="End_of_life" class="mw-headline">End of life</span></h3>
<p>Large areas of medicine are still missing statistical figures on the exact prognosis - in these matters the physician's previous experiences largely guides pronouncements in this matter. 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.</p>
<p>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.</p>
<h2><span id="Estimator" class="mw-headline">Estimator</span></h2>
<p>Estimators that are commonly used to describe prognoses include:</p>
<ul>
<li><i>Progression-free survival</i> - the length of time during and after medication or treatment during which the disease being treated (usually cancer) does not get worse.</li>
<li><i>Survival rate</i> - indicating the percentage of people in a study or treatment group who are alive for a given period of time after diagnosis.</li>
<li><i>Survival time</i> - the remaining duration of life. If not else specified, it is generally starting from the time of diagnosis.</li>
</ul>
<h2><span id="History" class="mw-headline">History</span></h2>
<p>Medieval European physicians would sometimes use numerology to calculate a prognosis, using the Sphere of Petosiris.<sup style="white-space: nowrap" class="Template-Fact" title="This claim needs references to reliable sources from June 2009"><font size="2">[<i>citation needed</i>]</font></sup></p>
<p>For the great 19th century physicians, particularly the French school, the main aim of medicine was not to cure disease, but rather to diagnose it and achieve a satisfying <i>prognosis</i> of the patient's chances. Only several decades later did the focus of efforts in Western medicine shift to curing disease.</p>
<h2><span id="See_also" class="mw-headline">See also</span></h2>
<ul>
<li>Diagnosis</li>
<li><a href="/wiki/Nocebo"><font color="#0645ad">Nocebo</font></a></li>
<li><a href="/wiki/Optimism_bias"><font color="#0645ad">Optimism bias</font></a></li>
<li><a class="mw-redirect" title="Placebo (origins of technical term)" href="/wiki/Placebo_(origins_of_technical_term)"><font color="#0645ad">Placebo (origins of technical term)</font></a></li>
<li><a href="/wiki/Prognostics"><font color="#0645ad">Prognostics</font></a></li>
<li><a href="/wiki/Reference_class_forecasting"><font color="#0645ad">Reference class forecasting</font></a></li>
<li><a class="mw-redirect" title="Sign (medicine)" href="/wiki/Sign_(medicine)"><font color="#0645ad">Sign (medicine)</font></a></li>
<li><a href="/wiki/Symptom"><font color="#0645ad">Symptom</font></a></li>
<li><a href="/wiki/Thought_experiment"><font color="#0645ad">Thought experiment</font></a></li>
</ul>
<h2><span id="References" class="mw-headline">References</span></h2>
<div class="reflist">
<div class="references">
<ol>
<li id="cite_note-0"><b><a href="#cite_ref-0"><font color="#0645ad">^</font></a></b> <span id="CITEREFGould.2C_SJ" class="citation">Gould, SJ, <a class="external free" rel="nofollow" href="http://www.prognosis.org/what_does_it_mean.php"><font color="#3366bb">http://www.prognosis.org/what_does_it_mean.php</font></a><span class="reference-accessdate">, retrieved 2009-01-07</span></span><span class="Z3988" title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=&rft.aulast=Gould%2C+SJ&rft.au=Gould%2C+SJ&rft_id=http%3A%2F%2Fwww.prognosis.org%2Fwhat_does_it_mean.php&rfr_id=info:sid/en.wikipedia.org:Prognosis"><span style="display: none"> </span></span></li>
</ol>
</div>
</div>
<h2><span id="External_links" class="mw-headline">External links</span></h2>
<ul>
<li><a class="external text" rel="nofollow" href="http://www.prognosis.org"><font color="#3366bb">Computer models at prognosis.org</font></a></li>
<li><a class="external text" rel="nofollow" href="http://www.ipgdx.com/PrognostiCheck_Overview.html"><font color="#3366bb">PrognostiCheck detects changes in tissue electrical properties and is a reliable and objective prognostic indicator in several chronic conditions.</font></a></li>
</ul>
