Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: Dr Taylor raises a concern about patients with somatoform disorders overreporting medical conditions and functional limitations, resulting in falsely elevated estimates of 4-year mortality risk. This highlights the importance of incorporating clinical judgment when interpreting the results from any prognostic index. Our index should be used in consultation with a clinician, so that prognostic information, patient preference, medical evidence, and clinician judgment can all contribute to the interpretation of risk scores. While we demonstrated that our index is accurate on a population level, the concern raised by Taylor is one of many reasons that a prognostic risk score may be less accurate when applied to an individual patient.
Lee SJ, Covinsky KE. Prognostic Index for 4-Year Mortality in Older Adults—Reply. JAMA. 2006;296(6):648-649. doi:10.1001/jama.296.6.648-c