SIGHTINGS



Doctors Too Optimistic
For Failing Patients
http://dailynews.yahoo.com/h/nm/20000217/sc/health_death_2.html
2-19-00
 
LONDON (Reuters) - Most doctors are too optimistic in predicting how long dying patients have to live, and this has a negative effect on the care they receive in their final days, American researchers said Friday.
 
A study by scientists at the University of Chicago Medical Center in Illinois showed that of the survival estimates for 486 terminally ill patients given by 343 doctors, only 20 percent were accurate.
 
Sixty-three percent of the predictions overestimated the time patients had left, and in some cases doctors predicted patients had five times longer to live than proved to be the case.
 
``Doctors are inaccurate in their prognoses for terminally ill patients and the error is systematically optimistic,'' Professor Nicholas Christakis and Dr Elizabeth Lamont said in a report in The British Medical Journal.
 
The researchers added that doctors who knew their patients best were more likely to get it wrong.
 
``Although some error is unavoidable...the type of systematic bias toward optimism that we have found in doctors' objective prognostic assessments may be adversely affecting patient care,'' the researchers added.
 
Instead of receiving three months of hospice care, which is considered to be the ideal, many patients received only one month's care because of the optimistic prognosis.
 
Patients who thought they had longer to live also opted for more aggressive treatment instead of palliative care, the report said.
 
The researchers suggested doctors should get second opinions from colleagues, particularly if they know a patient well, before giving a prognosis.
 
``Reliable prognostic information is a key determinant in both doctors' and patients' decision making,'' they added.

 
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