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The Importance of Prognostication in the Patient-Centered Care of Chronic Kidney Disease and ESRD Patients

  • 1 Alvin H. Moss, MD, is a professor with the Center for Health Ethics & Law in the Department of Medicine,West Virginia University in Morgantown, WV.
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A foremost goal of American medicine for the 21st century to improve the quality of health care is individualized, patient-centered care. The recommended means to achieve this care is shared decision-making, a conversation process in which the physician communicates information to the patient about diagnosis, prognosis, and treatment options and the patient communicates to the physician about his or her history, values, and treatment preferences. Together, the two share responsibility in reaching a common understanding of the patient’s preferred treatment course. This process has been called “the pinnacle of patient-centered care” (1).

Patient-specific estimate of prognosis

For patients