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To the Editor: Dr Lee and colleagues¹ reported the development and validation of a 12-item prognostic index for 4-year mortality in 2 cohorts of persons aged 50 through 85 years. The risk index has excellent discriminative power, indicated by a c statistic of 0.82 in the validation cohort. The authors conclude that the prognostic index can stratify patients 50 years or older into high-, intermediate-, and low-risk groups that may be useful for clinical decision making.

Age was the most powerful predictor of mortality, with a receiver operating characteristic area under the curve (AUC) of 0.75. Sex-specific age analyses would have yielded even higher estimates because of different mortality risk for men and women of similar age. Hence, the key question is what the 12-item prognostic index adds to the discriminant value of age and sex only.

We used the 2002 mortality statistics of the total Dutch population² to determine . . . [Full Text of this Article]

Anton J. M. de Craen, PhD
craen@lumc.nl

Rudi G. J. Westendorp, MD, PhD
Department of Gerontology and Geriatrics
Leiden University Medical Center
Leiden, the Netherlands

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