Prognosis research: Why is Dr. Lydgate still waiting?

BackgroundUnderstanding prognosis—the future risk of adverse outcomes among people with existing disease—plays third fiddle behind clinical research into therapeutic interventions and novel diagnostic technologies.Methods and ResultsDiseases show marked variations in a wide range of prognostic outcomes, yet these variations have seldom been the subject of systematic and sustained epidemiologic and multidisciplinary research. This is important to prioritize hypotheses for testing in intervention studies in groups, and to refine tools for prognostication in individuals. Methodologic standards for the design, conduct, analysis and reporting of prognosis research are required. Training is needed for the clinicians, policymakers, and payers who use prognostic information.ConclusionHere, arguments detracting from the potential scope of prognosis research are rebutted and misconceptions addressed with the aim of stimulating debate on the evolving role of prognosis research.