A preferred alternative is a single prognostic index (or perhaps a small number of indices) based on estimated life expectancy, a metric that is familiar to both physicians and patients. Values represent the life expectancy of persons at the 50th percentile (or median) in a specific population group. As noted by the authors, clinical guidelines increasingly incorporate life expectancy as a central factor in weighing the benefits and burdens of tests and treatments. Aligning the metric used to assess prognosis with recommendations in clinical guidelines would likely facilitate clinical decision making. A single estimate of life expectancy, for example, would allow a physician to advise an older patient about a large array of clinical decisions, such as whether to discontinue breast cancer screening or forego tight glycemic control for diabetes mellitus, as noted in Table 1 of the review by Yourman et al.
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