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» Checklist Can Help Determine Patient Life Expectancy

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For doctors trying to determine the health of their patients, the use of a basic checklist could help estimate whether older individuals will be alive in 10 years, according to the results of a new study.

Researchers at the University of California, San Francisco’s School of Medicine hope the results of the study will help seniors and their doctors establish a better level of communication regarding health care decisions.

Individualistic Care

Currently in the U.S., national guidelines on procedures such as breast cancer and colon cancer screenings provide general guidance, not individual recommendations. By adopting a checklist that addresses each patients individual medical needs, researchers believe doctors and senior patients will be encouraged to engage in meaningful discussions about screenings and other important testing.

The guidelines currently established by government health agencies for cancer and other basic screening tests vary, and some carry cutoff dates because not enough research exists that suggests testing benefits individuals over a certain age.

One example of how current practices can vary, the U.S. Preventive Services Task Force recommends that individuals begin undergoing regular colon cancer screenings from the age of 50 until 75. However the American Cancer Society does not provide a recommended age limit for colon cancer screenings, and instead suggests that doctors consider a patient’s health and life expectancy when determining whether to continue preventative testing.

For elderly individuals in poor health, continuing to aggressively test or screen for certain diseases can actually cause more harm than preventative good. However, a 75-year-old patient in great health may live for many additional years, and could benefit from screenings or aggressive treatments, such as tightly controlled blood sugar levels in those with diabetes.

Researchers believe that a use of a checklist could help to ensure that senior patients continue to receive beneficial testing while avoiding screening procedures that are unnecessary or could threaten their health.

Study Results

Compiling a checklist based on data compiled from a study of over 20,000 adults over 50 living in the U.S., researchers from the University of California, San Francisco discovered that, when considered together, 12 factors could provide doctors a quality understanding of a senior patient’s risk of dying within the next 10 years.

Among the 12 factors under consideration were physical limitations such as decreased mobility; whether the patient has conditions such as heart disease, lung disease, or diabetes; and the patient’s weight, sex, age, and status as a smoker.

Doctors can obtain the answers to these questions by asking patients simple yes or no questions, and then assign points for each questioned answered. The questionnaire then weights the answers to each question depending on the age of the patient. For example, patients between the ages of 60 and 64 would receive one point per yes or no answer, while those between the ages of 65 to 69 would get two points. A patient’s score would then determine his or her possible life expectancy.

Patients who score one point on the questionnaire would have, one average, a five percent chance of dying within the next decade. Patients who scored five points on the exam would have a 23 percent risk of dying within the next 10 years, while someone who scored 10 points on the questionnaire would have a 70 percent chance of dying.

Researchers behind the study argue that doctors need a better understanding of patients life expectancy because certain types of testing or preventative treatments only offer a benefit over the long-term. Patients with a low life expectancy could become exempt from certain forms of treatment if the short-term risks outweighed any potential long-term benefits.

Timothy Lemke is a freelance health and science writer. To read more of his work, visit the website of Dr. Cheryl Cooper, a Salem, OR dentist.

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