Yourman said that while the indices are of varying value and applicability, most have one component in common: “Functional status — the ability of the patient to carry out certain tasks and activities of daily living — was found to be statistically significant in predicting life expectancy in almost all of the indices we reviewed,” she said.

In compiling and analyzing the indices — winnowed down from an initial field of more than 21,000 related research titles — the researchers created a set of criteria, included on the website, that physicians can use to evaluate the quality of prognostic tools.

The first criterion is accuracy, which is the degree to which predicted outcomes match observed outcomes, said Smith, who is also a Greenwall Faculty Scholar in Bioethics and an assistant professor of medicine in the Division of Geriatrics at UCSF.

The second criterion is what the researchers term transportability — the extent to which an index was tested independently in patients with essentially different characteristics from the patient population in which it was first tested. “The more transportable the index, the more generalizable it is to other types of patients,” said Smith.

The third criterion, said Smith, is applicability: “Are the patients in which this index was studied similar to my own patient in key characteristics, such as age, functional impairments and co-morbidities?”

The research team also evaluated the bias of each index. “Let’s say that in developing a five-year mortality index, 10 percent of your subjects left the study before data collection was complete, and you weren’t able to assess their mortality over five years,” Smith explained. “It’s quite possible that they differed from the other 90 percent, and that may bias your results.”

Yourman said she hopes that other researchers will take advantage of the website to further test the indices in diverse patient populations. “We want to do our best to make sure that we help older patients make informed decisions about whether they will benefit from a treatment or not,” she said.

Co-authors of the study are Sei J. Lee, MD, MAS, of SFVAMC and UCSF; Mara A. Schonberg, MD, MPH, of Beth Israel Deaconess Medical Center, Boston, Mass.; and Eric W. Widera, of SFVAMC and UCSF.

The study was supported by funds from the National Institute on Aging, the Greenwall Foundation and the Clinical and Translational Science Institute at UCSF.

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