Doctors overestimate terminally ill patients' survival days by a factor of 5.3 | Hacker News Reader

Doctors overestimate terminally ill patients' survival days by a factor of 5.3

bmj.com

12 pointsNavinF7 comments

That chart shows one unfortunate person getting a prediction of 400 days, and dying one day after the prediction was made.

I wonder whether the cause of death was even related to the disease. That may explain some of the discrepancy: Doctors predicting when someone is likely to succumb to a specific thing, but discounting that something else may do them in first.

Not that extreme but my mother went from the doctor saying that her cancer was likely taken care of by surgery to dying from it 9 days later. I believe doctors could be off by 399 days easily.

Comparing estimated vs actual survival suffers from hindsight bias in the same way that you alluded.

Though it's still well known that doctors overestimate survival. Which is why they use tools like Palliative Performance Scale [1] to address this.

[1] https://www.mypcnow.org/wp-content/uploads/2019/02/e37642_38...

Sure makes it hard to plan for retirement

Pulls out soapbox

Which is why I cannot understand the “I can’t wait to retire”-crowd. Like sure, things will change and some things might get better (some things might get worse) but if you are just trying to get to retirement then I doubt you are enjoying your life now. I’ve watched many family friends talk about how much they hate their job (or it’s just obvious) and talk about retirement constantly.

Live your life _today_, if you aren’t happy then change things, don’t pin all your hopes on “one day I’ll retire and /that/ will make me happy” because I’ve got 2 things to say to that:

1. A switch doesn’t get flipped to make you happy when you retire. A week or two later I’ll bet you will still be miserable, just for other reasons (or maybe the same ones)

2. You might not make it to retirement due to illness, accident, etc.

My dad died last year at 59 years old. He never got to retire. But you know what? He lived almost every day of his life like it was his last, as if he had already retired. I wish he had more years with us but I know for a certainly that he did everything he wanted to do. There was no “one day I’ll be able to do X”, I mean there were dreams and plans for the future but they were never pushed off for any reason other than not having the means to accomplish them right then (like owning/having a bunch of cars he loved, but he owned many cars that he did love over the years and that was enough).

If you are miserable in your day job/normal life then don’t think it’s going to magically change when you retire. And even if a switch does get flipped in your mind you are not going to be physically able to do everything you might want to. Do it now, enjoy life now, don’t wait.

Did this take into account the effect the prognosis has on the patient?

What's the point of that prediction? If I were a doctor, I'd give a more optimistic prediction too, if only to make patients feel better.

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