Are disease mortality rates and survival rates complementary? If not, can they be related? Which is more relevant?

The relationship of mortality to survival is complicated and this paper suggests the two rates should both be defined for each condition or illness in order better to appreciate the projected real impact of the illness in question on patients. And if available conventional mortality data are "old" or not yet available, the above derived formula offers an alternate method of determining the mortality rate, provided one knows or can learn the prevalence of the illness and already has the more often published survival data. Physician lead discussions with patients today regarding such issues of survival and mortality often lead to the consideration of whether to undertake increasingly more invasive and/or expensive and complicated early diagnostic studies and/or interventions. The concerned patients and their families are many times relatively medically unsophisticated and not unexpectedly fearful. Both states of mind render them less able to understand complicated and, often to them, abstruse sounding explanations of their options. They most often default to the recommendation of their physician(s) and rely ultimately on sound analysis of the risks and probabilities of the alternatives by their doctor(s) to craft a course of investigation and therapy for them that is most likely to result in their improved outcome based on his or her judgment and experience. They trust the physician to optimize a plan for them. Therefore, in light of misleading conclusions a physician might draw by considering changes in survival statistics alone, it is worthwhile that he or she also understand and factor in mortality data that would follow in the wake of pursuing a recommended strategy. It is offered that use of the above derived formula: M = (1-S)*P provides a relatively simple tool for retrieving this more defining mortality statistic that is otherwise frequently more difficult to locate and is often not included in published reports of promising new investigative or therapeutic strategies. I propose, having personally accumulated more than desired patient perspective, it is essential for South Carolina physicians charged with responsibility of advising their patients on major and difficult choices understand the importance of and difference between these two outcome rates derived from both diagnostic studies and therapeutic interventions. The significance of these ratios or rates to and for the patient, especially if they conflict, should be conveyed to patients at the appropriate conversational level based on the education and understanding of the patient and his/her family. By comprehending and explaining both these ratios in layman's terms appropriate to each individual patient, a clearer understanding of the merit or lack thereof of the available options for that individual can be attained.

A century of cardiology as reported in The Journal of the South Carolina Medical Association.

Through the years, numerous articles and symposium issues in The Journal have provided South Carolina physicians with up-to-date information on strategies and technologies for diagnosis and management of heart diseases. The Journal has also featured articles on the epidemiology and prevention of heart disease, and on two occasions published the proceedings of national workshops on heart disease. During this interval heart disease crested as the most frequent cause of death in South Carolina and indeed in the United States. However, in the last three years, due to reduced cigarette consumption and other preventive and therapeutic advances, heart disease mortality has declined faster than cancer related deaths. As a result, since 2002, malignancies now kill more Americans than does heart disease. This victory, of sorts, creates an optimistic beginning of the second century of The Journal of the South Carolina Medical Association.