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Cutoff Value of Phase Angle by Bioelectrical Impedance Analysis at Admission as a Prognostic Factor in Patients with Acute Heart Failure
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Prognostication in palliative care.

Christina Chu1, Nicola White2, Patrick Stone3

  • 1University College London, London, UK and specialty trainee in palliative medicine, Barts Health NHS Trust, London, UK.

Clinical Medicine (London, England)
|July 17, 2019
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Summary
This summary is machine-generated.

Accurate prognosis for terminally ill patients aids care but clinician estimates are often unreliable. Acknowledging prognostic uncertainty is crucial for patient-centred discussions and shared decision-making.

Keywords:
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Area of Science:

  • Palliative Care
  • Medical Prognosis
  • Clinical Decision-Making

Background:

  • Accurate prognosis is vital for patient-centred care and shared decision-making in terminally ill patients.
  • Clinician-estimated prognoses are frequently unreliable and overly optimistic.
  • Prognostic uncertainty is inherent, especially at the end of life.

Purpose of the Study:

  • To review the reliability of clinician prognostic predictions.
  • To explore alternatives to subjective clinician estimates.
  • To emphasize the importance of acknowledging prognostic uncertainty.

Main Methods:

  • Literature review on prognostic accuracy and algorithms.
  • Analysis of factors influencing clinician prognostic decisions.
  • Synthesis of guidelines for prognostic conversations.

Main Results:

  • Clinician predictions alone are often inaccurate.
  • Validated prognostic algorithms show limited superiority over clinician judgment.
  • Several guidelines exist to support clinicians in prognostic communication.

Conclusions:

  • Prognostic conversations require acknowledging inherent uncertainty.
  • Patient-centred care and shared decision-making are enhanced by sensitive disclosure.
  • Further research may be needed to improve prognostic accuracy.