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Prognostication

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Neuropalliative Care

Abstract

A patient’s prognosis refers to the expected course of his or her disease process, including not only timing of eventual death but also future functional status and quality of life while living, with or without treatment. Understanding prognosis is central to establishing patient-centered goals and making decisions about disease-directed treatment as well as hospice, and represents one of the main elements of discussion when talking about serious news and establishing goals of care. Formulating an accurate prognosis for the neurologic patient presents a challenge for clinicians, who must weigh both subjective impressions and any available objective outcome data carefully. Communicating an estimated prognosis to a patient and his or her family—including talking about the prognostic uncertainty inherent in neurologic diseases—presents its own potential pitfalls. This chapter (1) outlines the central importance of prognosis in neurology, (2) highlights challenges that neurologists face in determining prognosis, and (3) discusses communication of prognostic estimates with neurologic patients and their families.

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Author information

Authors and Affiliations

  1. Department of Neurology, Yale University School of Medicine, New Haven, CT, USA

    Brian Mac Grory MB, BCh, BAO

  2. Division of Neurocritical Care and Emergency Neurology, Yale School of Medicine, New Haven, CT, USA

    David Y. Hwang MD

Authors
  1. Brian Mac Grory MB, BCh, BAO
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  2. David Y. Hwang MD
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Corresponding author

Correspondence to David Y. Hwang MD .

Editor information

Editors and Affiliations

  1. Assistant Professor, Department of Neurology, University of Washington Harborview Medical Center, Seattle, WA, USA

    Claire J. Creutzfeldt

  2. Professor of Neurology, Chief Neurology Supportive and Palliative Care Section, Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA

    Benzi M. Kluger

  3. Professor and Edward A. and Alma Vollertsen Rykenboer Chair, Department of Neurology, University of Rochester Medical Center, Rochester, NY, USA

    Robert G. Holloway

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Mac Grory, B., Hwang, D.Y. (2019). Prognostication. In: Creutzfeldt, C., Kluger, B., Holloway, R. (eds) Neuropalliative Care. Springer, Cham. https://doi.org/10.1007/978-3-319-93215-6_12

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  • DOI: https://doi.org/10.1007/978-3-319-93215-6_12

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  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-93215-6

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