Earlier quoted context omitted.
I never took the day off on my birthday, but a lot of people do. So it might also make sense to ask why these surgeons are operating on their birthdays. Did they take the day off and went back to perform surgery on a critical patient? Are they overworked? Etc.
Is that a thing in the US, taking a day off on your birthday? To the best of my knowledge, nobody does that in Europe - certainly not in the Netherlands.
Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
61–70 of 222 posts
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#62> They also found that some surgeons did not work on their birthdays Is this partially that better/more experienced/senior/more affluent doctors are taking their birthday off, hence people getting more junior doctors? It would be interesting to see how many more people die on a particular surgeons birthday compared with the rest of their year, rather than the birthday of the surgeon a patient gets.
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#63> They also found that some surgeons did not work on their birthdays Is this partially that better/more experienced/senior/more affluent doctors are taking their birthday off, hence people getting more junior doctors? It would be interesting to see how many more people die on a particular surgeons birthday compared with the rest of their year, rather than the birthday of the surgeon a patient gets.
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.
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#64> 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…
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.
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#65Earlier 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"
The comment you replied to has nothing to do with "correlation does not equal causation". The point was that fishing for results, by trying everything, is guaranteed to find something. So if, in a study like this, they looked at differences in morality rate between: 1) men and women, 2) younger and older people, 3) younger and older surgeons, 4) surgeries in summer vs winter 4) surgeries in morning vs evening 5) etc…
One simple way we can at least mitigate that problem is by requiring far lower p-values (or wider CI's), and where that's not feasible, require a much clearer-eyed explanation and acceptance of the fact that such research cannot be trivially supported by statistics, and instead additionally requires careful experimental setup and consideration of causal networks.
Basically: if you have p = 0.0001 or whatever I'm more willing to believe that publication biases and multiple testing aren't super likely to cause false positives that often. But without that, you want a clear hypothesis and proposed way to test published beforehand, and just one test, and ideally a clear hypothesis about causation etc too, so you can critically push and prod the results to try and distinguish noise from signal. A p=0.03 just isn't very obvious, at all.
In general, I think modern science is too reliant on statistics over complex systems, and in the effort to tease out significance then needs to try and correct for all kinds of known interference (confounders) and other effects; thus then need to use more advanced statistical models and less general assumptions about distributions (whether for significance, or for mathematical tractability), that it's just very hard for anyone to say they didn't make some systematic error somewhere. And sure, being an expert in the subject matter and having an expert statistician on hand helps, but making reasoning errors is too easy; too human to reliably avoid. Instead of seeking signals in noise, we should be targeting research more narrowly to parts of the puzzle that we can measure better, then use classical plain logic to put the pieces together - not try and measure the whole thing in one go. After we put all the well-measured pieces together, validating with tricky statistics is reasonable as a sanity check, but not much more than that. If common sense is hard, statistics is harder, even for statisticians.
Interpreting results like this as any more than "huh, that's something we could look into" is unwise.
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#66Earlier quoted context omitted.
Is that a thing in the US, taking a day off on your birthday? To the best of my knowledge, nobody does that in Europe - certainly not in the Netherlands.
It's probably just a personal thing. I'm in Europe and always take my birthday off - I don't understand why anybody would want to work on their birthday. Even if I don't have plans to celebrate until the weekend the idea of working on my birthday is very depressing (in fact in rarely celebrate my birthday and if I do it's something small like dinner with a couple of friends). To be honest I thought it would be more p…
Well, if you're lucky, your co-workers will chip in and buy a cake!
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#67> They also found that some surgeons did not work on their birthdays Is this partially that better/more experienced/senior/more affluent doctors are taking their birthday off, hence people getting more junior doctors? It would be interesting to see how many more people die on a particular surgeons birthday compared with the rest of their year, rather than the birthday of the surgeon a patient gets.
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.
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#68Earlier 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.
That, and since most planned surgeries ought to take place Mon-Fri, if anything it’s a higher percentage than I would have expected.
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#69Earlier quoted context omitted.
I never took the day off on my birthday, but a lot of people do. So it might also make sense to ask why these surgeons are operating on their birthdays. Did they take the day off and went back to perform surgery on a critical patient? Are they overworked? Etc.
Is that a thing in the US, taking a day off on your birthday? To the best of my knowledge, nobody does that in Europe - certainly not in the Netherlands.
People often bring cake to work on birthdays, though.
Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday
#70Earlier quoted context omitted.
I never took the day off on my birthday, but a lot of people do. So it might also make sense to ask why these surgeons are operating on their birthdays. Did they take the day off and went back to perform surgery on a critical patient? Are they overworked? Etc.
Is that a thing in the US, taking a day off on your birthday? To the best of my knowledge, nobody does that in Europe - certainly not in the Netherlands.