John R. asked the following question:
"What is your take on using the GAP Risk Assessment System as a tool to help determine a basic prognosis for the IPF patient?"
Here's my answer:
Thanks for bringing up the GAP score, John. For those who don't know about the GAP score, it is a simple tool that combines Gender, Age, and Pulmonary function test results (see the G-A-P there?) to help doctors predict how likely it is that someone with idiopathic pulmonary fibrosis (IPF) might die over the next three years.
The GAP score is an accurate tool that helps us identify people with IPF that should be considered for enrollment in clinical trials of new treatments or who might need lung transplantation. But the GAP score, just like any other prediction of the future, can't tell us what is going to happen to an individual person. Here's an example of what I mean.
Imagine that someone's GAP score was "4". About 1 out of 3 people with a GAP score of 4 will die over the following two years. This might mean that we should consider lung transplantation or enrollment in trials of new treatments -- in this way, the GAP score is indeed helpful. But this information actually does not help us know how long someone has left. Are you one of the "1 out of 3"? We still don't know the future.
Bottom line: Risk prediction tools like the GAP score can be very helpful for making decisions about treatment options, but are not really helpful if the question you are asking is "when am I going to die?" They can't answer those questions unless they predict a very high (>95%) or very low (>5%) risk, and in most cases, we don't need risk prediction tools when your risk is very high or very low, because it is often quite obvious when someone is very sick or very well.
While I do NOT recommend calculating your GAP score (for the reasons discussed above), I know everyone has already googled it. Here is a link to the calculator.
One more thing: the GAP score was developed in idiopathic pulmonary fibrosis (IPF) and may not apply to all of the other forms of Pulmonary Fibrosis. Many other forms of Pulmonary Fibrosis have better outcomes than IPF.