Medical prognosis — Some fundamentals

Background: The concept of prognosis as a prediction concerning the probable outcome of an attack of disease shows some severe contextual drawbacks in the everyday clinical sense. It is often used to describe possible outcomes of the disease in general, or the progression of a disease course, not the expected course in a particular case. Goal: To render more discriminating uses of the term prognosis, in order to provide the prognosticating physician with a valid tool, comparable to the theoretical basis of diagnostic and therapeutic actions. Procedures: Analysis and discussion of etymology, definition and practical usage. Conclusion: Prognosis is not to be considered soothsaying, but forecasting on qualified grounds. Prognostic statements are announcements containing prognostic information. Prognostic factors are pieces of information associated with a specific outcome of disease, which can be utilized in the formulation of the prognosis. Prognostic estimates involve subjective probability and can be formulated by using frequencies along with (clinical) experience. A prognosis is a prediction of a particular future stage of disease, considering a single case — the prognosis is neither part of the patient, nor part of the disease.     

What role do lay beliefs about hypertension etiology play in perceptions of medication effectiveness?

BACKGROUND: Some people take the disease label "hypertension" literally; leading to the belief that increasing relaxation instead of medication is the best treatment for this condition. We experimentally tested the effect of such underlying beliefs on ratings of interventions for hypertension and compared alternative communication strategies to increase medication effectiveness ratings. METHODS: Outpatients (N = 152) with a known diagnosis of hypertension read a vignette describing an asymptomatic condition and recommended treatment. Experimental factors were the disease label (Hypertension vs. Korotkoff's Syndrome) and type of argument designed to persuade the reader that medication is most effective (Causal vs. Correlational). MEASURES: Background measures included demographics, beliefs that stress causes health problems and trust in physicians. Outcomes were effectiveness ratings for interventions to treat the condition. RESULTS: Participants who read a vignette describing "Hypertension" rated "relaxing more" as significantly more effective than participants exposed to the same condition but with the unfamiliar "Korotkoff's Syndrome" label, [F(1, 141) = 5.22, p = .024]. However, medication, reducing salty foods and losing weight were rated as more effective than relaxing more. Intervention ratings did not differ by type of argument presented. There was a significant interaction of disease label and trust in physicians [F(1, 125) = 7.01, p = .009]. Individuals with low trust rated medication as significantly less effective when exposed to an unfamiliar disease label. CONCLUSIONS: This study confirms the effect of the hypertension disease label on ratings of different interventions for the condition. However, participants rated biomedically recommended interventions as more effective than those not endorsed.     

Examination of the Discriminant,Convergent, and Criterion‐Related Validity of Self‐Ratings on the Emotional Competence Inventory

We found that self‐ratings on the Emotional Competence Inventory (ECI) had small relationships with, but a distinct factor structure from, the Big‐Five personality dimensions. ECI self‐ratings were unrelated to academic performance and general mental ability. ECI self‐ratings had significant, albeit small, correlations with EC‐related behaviors and peer nominations of influence during a leaderless group discussion, coworkers' ratings of managerial skills, and number of promotions received. However, with one exception, these significant relationships disappeared after controlling for personality and age.