Alex Lee
speaker
101 appearances
1 recordings
1 series
first heard Oct 2022
last heard Oct 2022
Alex Lee’s voice in public audio — every appearance, attributed to the second.
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I think the more that they feel connected to the patient, it's often that.
that they'll kind of overestimate optimistically the person's life expectancy.
And so I think prognostic models are very important when we're um doing evidence-based medicine to really kind of standardize the playing field and make it so that these are objective, you know, projections of what someone has left in their life.
I'll just interject to say, you know, it's often said that all models are wrong, but some are useful.
And I think that's helpful to keep in mind that, you know, nothing is perfect.
Like there is so much randomness in all of these outcomes that you know no model is going to be perfect, but it's a matter of creating something that's going to be useful for whatever decision it's going to be used for and convenient also for the people who are going to be.
Using it both um
in terms of how they can do it practically, but also like what needs to be assessed to go into the model, whether that's age or disabilities or comorbidities.
Well, I think this is a
It's it's a very important issue that I think you know today really needs to be discussed and thought about very seriously.
I think we've seen a clear backlash among medicine in terms of using race specifically in these prognostic models for good reason that you know you would actually change some clinical decisions based on race alone if that's being you know pushing the model one way or the other that would make uh a clinical decision different.
Um, but I think socio um economic status, a lot of those indicators are very closely tied to race.
Um, and so you know, it could be that introducing some socioeconomic status predictors, say zip code, you know, if you have a highly segregated city, you're basically gonna have that zip code could actually just basically be a proxy or something that's essentially capturing.
you know, the black race, for example.
So I think I think it needs to be done sensitively.
I think obviously we know that people who um live in poverty or, you know,
Have had difficult circumstances during their lives, they're often more likely to have um a shorter lifespan.
And even you know, with a similar comorbidity index, comorbidity level, they might still have a shorter lifespan.
So that's certainly something to be considered, but we don't want to have kind of a feedback loop whereby, you know, people who are
Um, living in difficult circumstances, are then kind of in a sense discriminated against in medicine and given less intensive treatments that might actually benefit them.
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