Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

psychnewsdaily.com

Post reply on HN
Print view View original

81–90 of 222 posts

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#81

Post by jahller »

englishrookie wrote: post #38
spiderfarmer wrote: post #24

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.

German here: I always try to take a day off. Not as a rule in general, just a personal preference.

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#82

Post by ariejan »

englishrookie wrote: post #38
spiderfarmer wrote: post #24

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.

Well, I do. So there's at least one of us.

Then again, I grew up having my birthday in the "herfstvakantie" and the habit kind of stuck :-)

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#83

Post by kleiba »

helsinkiandrew wrote: post #16

> 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.

Those should be removed from the study.

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#84

Post by colonwqbang »

Ensorceled wrote: post #79

Anecdotally, my father-in-law was chief of staff for a small city hospital and they had a rule about not scheduling afternoon surgeries on important days like anniversaries, birthdays, etc. Basically, if the surgery started going long, you didn't want the surgeon worrying about missing their spouses birthday, birthday with their kids or an anniversary. It actually wasn't that many surgeries delayed, as the surgeon ju…

This is a beautiful conjecture!

The problem is amusingly circular. Even if you reject the conjure in parent comment, you will be tempted to reduce the number of birthday surgeries due to the increased mortality. This will mean that birthday surgeries are only done in even more desperate circumstances which of course will increase the risk.

So mitigation of this problem will lead to the percentage increasing even more! Actually, it turns out that it is possibly better if the percentage is high!

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#85

Post by Dylan16807 »

kkoncevicius wrote: post #19
voxl wrote: post #4

Earlier 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…

> Then it would be almost guaranteed that such a finding is spurious.

But that's the fallacy. You can't just preemptively assume that there are no real correlations.

You definitely want to use a smaller p threshold when you look for more things, but it's quite possible to hit real correlations with a pile of plausible hypotheses.

As an example: Let's say just 1/150 of your hypotheses hit a real correlation, and you're inappropriately using a p<.05 test. Tiny signal, huge noise. But even in that pessimistic case, more than 10% of your positives are real. Far from a guarantee.

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#86

Post by [deleted] »

quickthrower2 wrote: post #73

I’m going to guess (article won’t load for me) it is because the title should be “proportion of elderly deaths is 23% higher for surgery done on surgeons birthday” which might be a different thing if working on your birthday confounds with a certain type of surgery E.g. emergency surgery and being on call vs. elective surgery

[deleted]

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#87

Post by petercooper »

englishrookie wrote: post #38
spiderfarmer wrote: post #24

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.

It's debatable whether the UK is "in Europe" but all my employees take their birthdays off, as does my wife. It seems to be hugely common here. I don't do it though because I just don't see the point.

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#88

Post by danpalmer »

mhh__ wrote: post #52

https://www.england.nhs.uk/2019/01/surgical-safety-checklist... Getting surgeons to adopt the kind of "It's obvious but point and speak or you're fired"-style checklists a la operating an aircraft has reduced complications (from the minor to deaths) by several percent in the NHS. It's perhaps worrying given how low-hanging some of these fruit are - i.e. "Do we have the right patient?".

> It's perhaps worrying given how low-hanging some of these fruit are - i.e. "Do we have the right patient?"

It turns out that while it's a good idea to check things this "low-hanging", the value is far larger than catching wrong patients, so don't worry too much!

Much of the value comes from essentially disrupting routine with an opportunity to stop, and from creating a culture of speaking up. I think the NHS was the organisation to trial having the nurse run the checklist, which had the effect of empowering the "lowest level" person in the operating theatre. Studies showed that even just having everyone in the room speak once increased the chance of subsequent communication, and ultimately improved patient outcomes.

Atul Gawande was one of the key people in designing and rolling out these checklists and wrote a book about it that I'd recommend – The Checklist Manifesto.

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#89

Post by danpalmer »

onehp wrote: post #74
Reason077 wrote: post #66

Earlier quoted context omitted.

> "I don't understand why anybody would want to work on their birthday." Well, if you're lucky, your co-workers will chip in and buy a cake!

In all the work environments I've been in (UK) the culture is the opposite, as the birthday person you are expected to bring in cake.

And I've had exactly the opposite experience in the UK. I think this depends entirely on the workplace.

Re: Elderly patients 23% more likely to die if surgery is on the surgeon’s birthday

#90

Post by Reason077 »

onehp wrote: post #74
Reason077 wrote: post #66

Earlier quoted context omitted.

> "I don't understand why anybody would want to work on their birthday." Well, if you're lucky, your co-workers will chip in and buy a cake!

In all the work environments I've been in (UK) the culture is the opposite, as the birthday person you are expected to bring in cake.

In that case, I'd be trying to keep my birthday a secret!
Post reply on HN