Patients and family members use various sources of information to come up with their own prognostic estimates, with only a small minority relying solely on a physician’s estimate. Therefore, it would be important for physicians to describe the various factors that may be influencing their prognostic estimates.

Notice how the clinician in this example does the following step:

1. Provide context behind their prognostic estimate by including factors that led to their prognostic estimates.

Take a minute to think about what worked well in this example and what can be done differently.

• “Half of people like you, who have been admitted to the hospital for heart failure, will die in a year.”
• “For someone with cancer of your type that has spread at diagnosis, 1 out of 5 will be alive at 5 years.”
• “Based on the system we use to evaluate severe liver failure like yours, 70% of patients with your level of disease will die in 3 months.”
• “For someone of your age, with your set of medical conditions and ability to take care of yourself from day to day, most of them pass away at 5 years.”

1. Back AL, Arnold RM. Discussing prognosis: “How much do you want to know?” Talking to patients who are prepared for explicit information. J Clin Oncol. 2006 Sep 1;24(25):4209-13.
2. Hagerty RG, Butow PN, Ellis PM, Dimitry S, Tattersall MHN. Communicating prognosis in cancer care: A systematic review of the literature. Ann Oncol. 2005 Jul;16(7):1005-53.