Accurate prognostications of death. Opportunities and challenges for clinicians.

Linking survival time to an array of prognostic variables through a powerful statistical model can provide reliable, valid and potentially useful information for patient care. We present a summary of the recently developed SUPPORT model [Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment] for estimating survival time of seriously ill adult inpatients and illustrate the possible clinical use of such a model. This model is then translated into counseling. Clinicians are positioned to evaluate the relevance and validity of any model and to understand their persistent shortcomings.