Thursday, March 27, 2008

Can computers make life-or-death medical decision?

New Scientist: by Roxanne Khamsi

A simple formula can predict how people would want to be treated in dire medical situations as accurately as their loved ones can, say researchers.

The finding suggests that computers may one day help doctors and those acting as surrogate decision-makers to better estimate the wishes of people in a coma. ...

Bioethicist David Wendler of the National Institutes of Health in Bethesda, Maryland, US and colleagues wondered whether a formula could be used to better predict a patient’s wishes. They examined information collected by pollsters and scientists about the attitudes towards medical care held by the general US population.

The data suggested that most people want life-saving treatment if there is at least a 1% chance that following the intervention they would have the ability to reason, remember and communicate. If there is less than a 1% chance, people generally say they would choose not to have the treatment.

“The difference between zero and 1% is all the difference in the world for someone,” says Wendler.

Surprising accuracy

His team then looked at subset of the 16 studies in which the medical scenarios were judged to be easier for a member of the public to understand. In these casea, they found that surrogates predicted the patient’s wishes more accurately, 78% of the time. But surprisingly, using the formula that people only want interventions if there is a 1% chance of a good outcome had the same accuracy.

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