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Deciding when
to "start the clock" for survival analysis or time to
death analysis can be difficult because, from a clinical perspective,
it should start at some replicable point in time, such as when
the physician recognized that the patient was "terminally
ill". There is, however, no code for terminal illness. Hospice
entry is a surrogate but is limited to the hospice users and does
not take into account the time prior to hospice entry when care
decisions may have been made. For persons not enrolling in hospice,
there is no clock to start.
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