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Showing posts from April, 2019

Are Palliative Care Providers Better Prognosticators? A Podcast with Bob Gramling

Estimating prognosis is hard and clinicians get very little training on how to do it.  Maybe that is one of the reasons that clinicians are more likely to be optimistic and tend to overestimate patient survival by a factor of between 3 and 5.  The question is, aren't we better as palliative care clinicians than others in estimating prognosis?  This is part of our training and we do it daily.   We got to be better, right?  Well, on todays podcast we have Bob Gramling from the Holly and Bob Miller Chair of Palliative Medicine at the University of Vermont to talk about his paper in Journal of Pain and Symptom Management (JPSM) titled “ Palliative Care Clinician Overestimation of Survival in Advanced Cancer: Disparities and Association with End of Life Care ”. Big findings from this JPSM paper include that we, like all other clinicians, are an optimistic bunch and that it actually does impact outcomes.   In particular, the people whose survival was overestimated by a palliativ

Multimorbidity - Quantifying It's Impact on Mental and Physical Health: A podcast with Melissa Wei

On today's podcast we talk with one of the national experts on multimorbidity, Melissa Wei.   Dr. Wei is an Assistant Professor and physician researcher at the University of Michigan.   In addition to destroying the lyrics to Bohemian rhapsody, we talk to Dr. Wei about how we should conceptualize multi morbidity, it's impact on older adults, and about her recent JAGS publication titled " Multimorbidity and Mental Health-Related Quality of Lifeand Risk of Completed Suicide ." We also go a little deeper into a measure of multimorbidity that Melissa created, the Multimorbidity Weighted Index (MWI) that weights diseases to patient reported physical functioning.  The MWI is associated with physical and cognitive function and mortality.  If you listen to the podcast, you'll notice that we also mention ePrognosis.  That's because Melissa's Multimorbidity-Weighted Index can now be found on the site ( ). So take a take a