With the recent diagnosis of glioblastoma in Senator Edward Kennedy, the press asked the "time" question: "How much time does he have left." As we know, most patients succumb within 12-18 months after diagnosis. 1 Estimating disease outcomes within a range can be done with some confidence. It is more difficult to predict the outcome for an individual patient. Medical prognostication, "a prediction of future medical outcomes of a treatment or a disease course based on medical knowledge," 2 has become something of a lost art. Prognosis, diagnosis, and therapeutics make up the main clinical skills in medical practice. Seventy-five years ago, when most effective medical therapies did not exist, the most skilled physicians were astute diagnosticians and frequent prognosticators. 3 Today, in the exam or intensive care room, discussion focuses on diagnos- tic and therapeutic options. Prognostication takes a back seat. Some of this relative neglect may come from the hope that prog- nosis will not be necessary, that cure will be the outcome. Medicine has delineated four major trajectories for the common causes of death.
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