4 Year Prognostic Index

4 Year Prognostic Index
Demographics
[select name="Q1" value="60 to 64 (1 point)=1|65 to 69 (2 points)=2|70 to 74 (3 points)=3|75 to 79 (4 points)=4|80 to 84 (5 points)=5|85 and over (7 points)=7"] <-- Age (years)
[select name="Q2" value="Female (0 points)=0|Male (2 points)=2"] <-- Gender
[select name="Q3" value="No (0 points)=0|Yes (1 point)=1"] <-- Diabetes
Comorbidities and behaviors
[select name="Q4" value="No (0 points)=0|Yes (2 points)=2"] <-- Cancer (other than minor skin cancer)
[select name="Q5" value="No (0 points)=0|Yes (2 points)=2"] <-- Chronic lung disease (disease limits activities or patient requires oxygen)
[select name="Q6" value="No (0 points)=0|Yes (2 points)=2"] <-- Heart failure
[select name="Q7" value="No (0 points)=0|Yes (1 point)=1"] <-- Body mass index < 25 kg/m2
[select name="Q8" value="No (0 points)=0|Yes (2 points)=2"] <-- Current smoker
Functional measures
[select name="Q9" value="No (0 points)=0|Yes (2 points)=2"] <-- Because of a health or memory problem do you have any difficulty with bathing?
[select name="Q10" value="No (0 points)=0|Yes (2 points)=2"] <-- Because of a health or memory problem do you have any difficulty with managing finances?
[select name="Q11" value="No (0 points)=0|Yes (2 points)=2"] <-- Because of a health or memory problem do you have any difficulty with walking several blocks
[select name="Q12" value="No (0 points)=0|Yes (1 point)=1"] <-- Because of a health or memory problem do you have any difficulty with pushing/pulling heavy objects?
Score --> [calc memo="Score" value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)+(Q10)+(Q11)+(Q12)"] out of 27 points
Interpretation --> [calc memo="Interpretation" value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)+(Q10)+(Q11)+(Q12);score>13?'64%':score>9?'42%':score>5?'15%':'<4%'"] 4-year mortality risk
[checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"]
reference:  
[link url="//www.ncbi.nlm.nih.gov/pubmed/16478903" memo="#1"] Lee SJ, Lindquist K, Segal MR, Covinsky KE. Development and validation of a prognostic index for 4-year mortality in older adults. JAMA 2006;295:805
[link url="//www.ncbi.nlm.nih.gov/pubmed/16939186" memo="#2"] Predicting Four-Year Mortality Risk in Older Adults</a>, Am Fam Physician. 2006 Aug 15;74(4):633-634.
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