Prognosis
Better information = better estimates
Of all major components of chronic disease management, the science of prognosis is perhaps the most inexact.
In a sense, it means “jumping ahead” on the disease management timeline by predicting a future outcome based on an individual patient’s present condition. The chance of prediction error can be great due to the number and nature of unknowns inherent to the process, with potentially serious downstream effects on patient health and well-being. That said, prognosis is typically informed by multiple pieces of information that, when weighted appropriately and checked against changing circumstance, are useful in helping maximize the accuracy of a predicted outcome.
Prognosis is made largely on the basis of historical data, i.e. the normal course a disease has already followed in many patients treated over a large time period. This data is pooled together with an individual patient’s physical and psychological state, along with further considerations such as the therapies currently available for treating the condition.
Ultimately, a patient-specific prognostic report will include:
- Estimates on disease progression and duration
- Efficacy of proposed treatments
- Potential for complications
- Likelihood of remission
- Life expectancy and/or quality-of-life issues
A guide for doctors and patients
Prognosis plays a vital role in disease management on a few fundamental levels. Most concretely, clear expectations of a disease’s future effects on a patient are needed to design a treatment plan that can mitigate or prevent those effects. The availability (or not) of promising therapies will certainly influence prognosis, as will patient factors such as an individual’s physical or psychological tolerance for existing drug regimens or lifestyle adjustments proposed as treatment.
Just as establishing prognoses helps medical professionals decide on courses of treatment, receiving prognoses helps patients make important decisions of their own: whether or not to accept certain treatments, how to adapt their lifestyles to their conditions, how to best manage their own health for the most benefit to themselves, their families and their communities — a type of patient empowerment that effective disease management programs all strive to achieve.
