Online Mortality Calculator Could Change Health Care — and Our Views on Death
A “mortality calculator” created by medical researchers for doctors is now available to anyone online. Josh Dzieza on how it could change health care—and the way we think about death.
When a team of researchers at University of California, San Francisco, started collecting tools for predicting the likelihood of death, they thought their work would be used primarily by physicians. But the project ended up as an interactive tool that would be of interest to medical professionals, elderly patients—and the morbidly curious alike.
The site, ePrognosis.org, displays 16 different methods for determining a person’s chances of dying in the near future. The team designed the site so that doctors could have something better to go on than average life expectancy and intuition when deciding what treatments to recommend for elderly patients. The hope is that a better understanding of life expectancy will help patients and doctors decide on treatments—for instance, sparing a patient with advanced cancer from an invasive procedure for an ailment that likely will never have the chance to become a problem.
The tools aren’t new. Many were publicly available before, or kept behind medical-journal paywalls. But this is the first time so many have been assembled in one place, ranked according to their accuracy, and made so user friendly. A doctor—or anyone who clicks a button saying she’s a doctor—can plug in the relevant medical information and get a prognosis: 59 percent chance of dying within four years for an elderly diabetic male smoker with a history of congestive heart failure, for example.
Some worry that the apparent clarity of that number will mislead laypeople. “It’s not a crystal ball,” says Carol Levine, director of the families and health-care project at the United Hospital Fund. She says that prognosis is a serious matter and should be discussed one-on-one with a professional.
Ken Covinsky, also at UCSF, has a similar concern. “Your radiology report is shrouded in medical terminology, so you’d go over it with your doctor,” he says by way of comparison. “But the number on the prognosis calculator is easily understood.” He cautions that these indices are developed for populations, not individuals. The number is the average life expectancy for a population, which has a huge range within it. Individuals often outlive their life expectancy by quite a lot, he says. “Maybe they have an illness the index accounts for, but it’s a mild case.” Users might also undershoot their prognosis, if they have one of the many illnesses the index doesn’t account for. “I’d tell someone using it that they’re an individual, not a population.”
Suppose you had fewer than five years to live. Would you want to know? To read the article in full, click here.