Diagnosis vs. Prognosis: What’s the Difference?

Healthcare terminology can be very confusing, especially when you are trying to understand difficult or emotional news. Two terms that are easy to confuse are diagnosis and prognosis.

What’s the difference between diagnosis and prognosis?

Diagnosis

A diagnosis is the identification of a disease, condition, or injury from its signs and symptoms. Your healthcare team may use your health history, a physical examination, tests like blood work, imaging like x-rays or a CT scan, and biopsies to help determine your diagnosis.

For example, if a patient comes to their doctor with symptoms like fever, a cough, and body aches, the doctor might run tests like a COVID-19 antigen or PCR test, a rapid influenza diagnostic test, and blood work. Depending on the results, the patient may be diagnosed with COVID-19, the flu, or another infection.

Based on the tests and other information gathered, the diagnosis may also be able to provide more details on your condition such as cancer type or the stage of the disease.

Prognosis

A prognosis is a medical professional’s educated prediction about the likely course and outcome of a disease or condition.While a diagnosis identifies a specific illness or condition, a prognosis offers an informed prediction about how that condition is likely to progress. It helps patients and their families anticipate outcomes, make treatment decisions, and plan for the future. 

Prognosis is based on a combination of factors, including:

• The type and stage of the disease.
• How quickly the condition is likely to advance.
• Response to treatment options.
• The patient’s overall health, age, and other medical conditions.

For example, your healthcare provider may talk about your prognosis in terms of a time range. They might say: "Based on survival statistics and your specific prognostic factors, you have a prognosis of three to five years to live."

This type of prediction is not an exact timeline but rather a reflection of outcomes seen in similar cases. Prognoses can change over time depending on how the disease progresses and how well a patient responds to treatment.

Understanding your prognosis can help you and your loved ones make informed decisions about care, treatment preferences, and planning for the future.

Types of prognosis.

Medical professionals often categorize prognosis into four main types, each reflecting the anticipated course of a condition:

1. Favorable (good) prognosis
Indicates a high likelihood of recovery or effective disease management. Patients can often expect a return to normal activities with appropriate treatment. 

2. Intermediate (moderate) prognosis
Suggests a mixed outlook. While the condition may not be life-threatening in the immediate future, there could be ongoing health challenges or functional limitations. 

3. Poor (severe) prognosis
Reflects a serious condition with a significant risk of death or substantial life limitations. This prognosis often necessitates comprehensive care planning and support. 

4. Guarded prognosis
Denotes uncertainty regarding the disease's progression. This is common when insufficient information is available, such as in early stages of diagnosis or complex cases. 

Levels of medical prognosis.

Beyond these categories, healthcare providers may describe prognosis using qualitative terms that convey the expected outcome's favorability:

• Excellent: The condition is expected to resolve fully with treatment.
• Good: A strong response to treatment is anticipated, with minor residual effects.
• Fair: Some improvement is expected, though challenges may persist.
• Poor: Limited improvement is anticipated, with significant health implications.
• Guarded: The outcome is uncertain, and close monitoring is required.

Factors influencing prognosis.

Several elements can impact a patient's prognosis, including:

• Disease characteristics: Type, stage, and aggressiveness of the condition.
• Patient factors: Age, overall health, and presence of other medical conditions.
• Treatment options: Availability and effectiveness of therapies.
• Response to treatment: How well the patient responds to interventions.
• Functional status: The patient's ability to perform daily activities.

Understanding the type and level of prognosis provides valuable insight into the expected course of an illness, aiding in informed decision-making and care planning.

Crossroads Hospice & Palliative Care provides support to terminally ill patients and their families. Patients diagnosed with a terminal illness often hear terminology they are unfamiliar with from doctors, nurses, and other care providers. Our hospice terminology glossary provides easy-to-understand explanations. To learn more, please call us at 1-888-564-3405.

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