Clinical prognostic methods: Trends and developments Guest-Editorial

摘要

Prediction of health related patient outcomes is increasingly recognized as an essential activity in clinical decision making, clinical research, and healthcare quality assessment [1-8]. In clinical decision making, treatment is typically initiated if a poor outcome is predicted when leaving a condition untreated. For instance, European guidelines on cardiovascular risk management [9] recommend that the decision of initiating preventive treatment is based on the SCORE function [10], which estimates the ten-year risk of fatal cardiovascular disease for a given individual. Similarly, prognostic considerations are usually paramount when choosing among competing therapies. In clinical research, selection of patients for clinical trials is often based on illness severity at baseline, expressed as the risk of a poor outcome, which is derived by a prognostic model. In healthcare quality assessment, fair comparison between care providers requires that observed outcomes (such as mortality) are compared with outcomes that one would expect when considering the mix of patients who were treated (case-mix adjustment).