Solution, allow doctors and surgeons time off from bday!
Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
211–220 of 222 posts
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#212Earlier quoted context omitted.
I remember a previous study showing that junior doctors were actually associated with better results since they were more recently trained and had less ingrained habits/biases. Don't know if it applied to surgery though.
I would be surprised if it did. I believe the reduction in doctors’ overtime was a wash for parent safety as more shift handoffs and less sleep deprivation more or less canceled except in surgery where it increased mistakes.
Those studies are silly though—-the “reduced” schedule is often still something like 24 hours on-duty (vs 28).
Hand-off is also something that could, in principle, be improved whereas long shifts are just butting up against the limits of human physiology.
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#213> Research on judges has yielded similar results. It has found, for example, that external factors as diverse as outdoor temperatures and sports results can influence judges’ decisions. When I hear of these funky effects I always wonder how they relate to AI. Presumably this is somehow related to some kind of lossy compression of the state of the world, maybe similar to principal components[0]? Where the "I feel grum…
I don't have a reference handy, but I seem to recall that that study on judges' verdicts being influenced by temperature, how close they were to lunchtime and so on, failed to replicate. I wouldn't be surprised if the OP study fails to replicate as well. They have a relatively high number of data points (to get an idea of order of magnitude: mortality of 145 across 2064 operations on birthdays) but only reach a P-val…
The judges-at-lunch thing turned out not to be a good “natural experiment” because the prisoners were systematically ordered.
The parole board considered cases from one prison at a time. Within each prison, prisoners representing themselves went last and they tended to fair worse than those with attorneys. The judges tended to take meal breaks between prisons, and....poof, there’s the result.
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#214> Research on judges has yielded similar results. It has found, for example, that external factors as diverse as outdoor temperatures and sports results can influence judges’ decisions. When I hear of these funky effects I always wonder how they relate to AI. Presumably this is somehow related to some kind of lossy compression of the state of the world, maybe similar to principal components[0]? Where the "I feel grum…
Also interesting is "Impossibly Hungry Judges". Many of these correlation effects are paradoxically so strong that they they _cannot_ be the true explanation. [0] http://nautil.us/blog/impossibly-hungry-judges
Yup. Even ignoring the lack of randomization, there’s another issue with the hungry judges paper that should have raised some eyebrows.
They fit a model using both the case order (1st, 2nd, 3rd, etc) and the time elapsed. Either is significantly related to the case’s outcome, but when both are included, the rank explains away the time elapsed. This is obviously not compatible with increasing hunger/decreasing blood sugar, since those should depend on wall-time.
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#215Earlier quoted context omitted.
You make a good point, though I'd like to add that one would expect 1/365 = .274% of procedures to be on a random day (like a birthday). .21% is not so far off that it can't be random chance.
> .21% is not so far off that it can't be random chance How far off exactly would it need to be before it can be random chance?
Interesting question, wondered that myself as well. My statistics are a little rusty, so doing a quick simulation shows that the range is about .25-.29 (code sample 1). However, things like operations aren't completely random, and you might be more correct by looking at something like a Poisson process, resulting in a range of about .14-.44 for this sample size (code sample 2).
All in the end to be taken with a grain of salt of course, as the planning component of operations eliminates most statistical properties :)
``` operations = np.random.randint(0, 365, 980000) pd.Series(operations).value_counts().sort_values() / 980000 ```
``` x = np.random.poisson(.0089, 1000000) x = (pd.Series(x).cumsum() / 24).round() x.groupby(x).count().iloc[:365].sort_values() / 980000 ```
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#216Earlier quoted context omitted.
I feel like we need an opposite saying for sentiments like this to the age old "correlation does not equal causation", something like "correlation does not mean automatically dismiss"
How about "if you find a correlation and want to report this as if you think it's significant, then you should formulate a specific hypothesis and perform independent experiments to test it, rather than publishing junk."
Apparently this isn't junk: I couldn't access the original at the time of posting, so I relied on a second hand bogus interpretation. Apologies!
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#217> The study, which appears today in the British Medical Journal (BMJ), looked at 980,876 procedures performed in US hospitals by 47,489 surgeons. Of those procedures, 2,064 (0.2%) took place on a surgeon’s birthday. So, only a fraction of the surgeons performed operation on their birthdays. Would be interesting to compare the outcomes using the same surgeon group: surgeries on birthday vs same-surgeon surgeries on ot…
If they didn’t change the schedule at all, 100/365 percent of all surgeries would be on the surgeons birthday. Which is 0.27%.
Put another way, assuming a flat distribution, on any given day 980876/365 = 2687 surgeries happen. While apparently on their birthday it’s 2064.
Saying ‘only a fraction of the surgeons performed operation on their holidays’ is a strong exaggeration. It’s about 75% of surgeons.
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#218How come nobody mentioned the day after the surgeon's birthday?
What makes that day more special than 2 days after the surgeon's birthday? Or any other "normal" day of the year.
If there was a party on Surgeons Birthday, he might be hung-over the next day. Like the day after Christmas. or New Year.
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#219I recently had a complex facial surgery. Before doing so, I tracked all informations I could about my surgeon. Everyone had good comments, good healing, very impressive track record, etc. Everyone but one patient. She complained on how her surgery was rushed, how quick she was out of the operating theater, how she is scarred from it, etc. At first, I thought she was lying. Why was she such an outlier? I asked her for…
Just a note, this (and many) titles report _releative_ change as the percentage. E.g. 1% -> 1.5% report as "50% increase". It is IMHO very misleading. At one point I developed a gut reaction to any statistic "Relative or absolute".
6.9% vs 5.6%. Still a big increase and that's just the deaths. I would imagine that errors follow a similar curve.
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#220Earlier quoted context omitted.
But the more you avoid birthday surgeries altogether, the more those that end up still happening are extreme cases with high mortality rates. So if your target is to avoid this scary statistical anomaly, you might instead want to promote more benign surgeries on birthdays.
The types of surgeries performed should be controlled for when performing a statistical study.
They were. This entire line of criticism comes from not reading the study methods.