How to model life’s trajectory from major diagnosis to death

Illness trajectories are a useful tool for understanding how individuals with progressive illnesses will likely experience decline over time. There are three established trajectories: rapid for cancers, intermittent for declining organ function, and gradual for frailty or neurological conditions. A new trajectory for multimorbidity is now proposed. The complexity and unpredictability of these trajectories make them suited to modern data and analytics tools. New cancer treatments have also added challenges and unpredictability to established trajectories. Diagnostic methods like capsule endoscopy are emerging, while ethical issues in pharmaceutical industry influence, exposed by whistleblowers like Nancy Olivieri, continue to be a concern. Journals, including predatory ones, can exacerbate these issues. Personal stories, like that of former BMJ colleague Linda Beecham, highlight the importance of understanding and addressing illness trajectories in healthcare.

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