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Editor's Correspondence
Jan 23, 2012

The Clinical Utility of Prognostic Indices: The Proof of the Pudding Is in the Eating

Author Affiliations

Author Affiliations: Department of Primary and Community Care, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.

Arch Intern Med. 2012;172(2):194-195. doi:10.1001/archinte.172.2.194

In addition to the study by Siontis et al1 that explored the clinical utility of prognostic indices, we would like to highlight the questionable state of prognostic index reporting for chronic obstructive pulmonary disease (COPD), one of the most important causes of worldwide mortality.2 As yet, 16 prognostic indices for patients with COPD have been published, with various reporting of validation measures; whereas discrimination was assessed in 10 indices, calibration was assessed only once.3,4 Although most prognostic COPD indices were intended to improve patient care, none were ever studied for its impact on patients' well-being, health care utilization, or mortality. Airflow obstruction is still the only structured measure in clinical COPD guidelines for making medical decisions, along with patients' stated well-being.