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• Disease progression or deterioration?
  G Stern
  Published on: 15 March 2011

• Published on: 15 March 2011

  Disease progression or deterioration?

  • G Stern

  Most authorities, from Samuel Johnson's to the current Oxford University Dictionary, define "progression" as a change for the better stemming from the Latin "prograde" to improve continuously and "deterioration" as a change for the worse (Latin "deteriore"). Yet most neurological journals appear to accept "disease progression" (as in secondary progressive multiple sclerosis and progressive supranuclear palsy) to indicat...

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  Most authorities, from Samuel Johnson's to the current Oxford University Dictionary, define "progression" as a change for the better stemming from the Latin "prograde" to improve continuously and "deterioration" as a change for the worse (Latin "deteriore"). Yet most neurological journals appear to accept "disease progression" (as in secondary progressive multiple sclerosis and progressive supranuclear palsy) to indicate that the natural history of an illness is deteriorating in character; most patients and their families would not agree. The most insensitive of neurologists would hardly tell an anxious family that their dear one's terminal illness was progressing. While lexicographers emphasise the dynamic flexibility of language, I doubt whether they would favour contrary ambiguity. Nor would they agree with a definition expressed in "Alice through the looking glass". "When I use a word "Humpty Dumpty said in a rather scornful tone, "it means just what I choose it to mean - neither more nor less". It seems legitimate to propose that "progression" should be applied to the disease process and hopefully to its elucidation, and that "deterioration" should apply to the history of a patient's illness. Perhaps the author's conventional confessions at the end of a submitted article, such as competing interests, provenance and particularly patient's consent should also indicate whose side they are on: the disease or the patient?

  Gerald Stern

  University College Hospitals, Queen Square, London WC1

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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