X-Message-Number: 13266
Date: Thu, 17 Feb 2000 22:50:18 -0500
From: Jan Coetzee <>
Subject: hospice care

Doctors Too Optimistic for Dying Patients-Study

LONDON (Reuters) - Most doctors are too optimistic in predicting how
long dying patients have
to live, and this has a negative effect on the care they receive in
their final days, American
researchers said Friday.

A study by scientists at the University of Chicago Medical Center in
Illinois showed that of the
survival estimates for 486 terminally ill patients given by 343 doctors,
only 20 percent were

Sixty-three percent of the predictions overestimated the time patients
had left, and in some cases
doctors predicted patients had five times longer to live than proved to
be the case.

``Doctors are inaccurate in their prognoses for terminally ill patients
and the error is
systematically optimistic,'' Professor Nicholas Christakis and Dr
Elizabeth Lamont said in a
report in The British Medical Journal.

The researchers added that doctors who knew their patients best were
more likely to get it

``Although some error is unavoidable...the type of systematic bias
toward optimism that we have
found in doctors' objective prognostic assessments may be adversely
affecting patient care,'' the
researchers added.

Instead of receiving three months of hospice care, which is considered
to be the ideal, many
patients received only one month's care because of the optimistic

Patients who thought they had longer to live also opted for more
aggressive treatment instead of
palliative care, the report said.

The researchers suggested doctors should get second opinions from
colleagues, particularly if
they know a patient well, before giving a prognosis.

``Reliable prognostic information is a key determinant in both doctors'
and patients' decision
making,'' they added.

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