Louisville Medicine Volume 63, Issue 2 | Page 38

DOCTORS’ LOUNGE time spent using the computer, a variable the EMR-burdened clinician can relate to, mattered a lot less than the above. The Ubble quiz data can be interrogated online in the Association Explorer, wherein one can change the “predictor of mortality” category for both men and women. In addition, we can calculate our “Ubble age.” Remember, we are comparing ourselves to middle-aged Britons (and the Welsh and the Scots). Data analyzed here cover only three years to date: so if your Ubble age seems unreasonably high, buck up. More data will inevitably follow. Once you’ve answered the questions, you instantly find out if you are biologically riskier than your actual age, or ahead of the curve. The Lee Index, from Dr Sei Lee out of UCSF, has a greater focus on specific 36 LOUISVILLE MEDICINE medical illnesses and details about daily functioning. Dr Lee has been researching mortality prediction for many years, and runs his “death calculator” on the www. eprognosis.org website (www.eprognosis. ucsf.edu/lee-result.php). It can be used to estimate life expectancy for the purpose of conducting screening tests or prior to proposing expensive or difficult or risky treatment, to help in deciding whether the “remaining” lifetime benefit outweighs the proposed risk. It can also be used to test the clinician’s accuracy in predicting mortality, as compared to that of multiple validated indices, since Dr. Lee helpfully provides other sources as well. (One could here compete with colleagues, a sort of macabre pub quiz; I advise not to take on a pathologist). To cheer yourself up after all this death and dying (unless you actually dig the Game of Thrones, where everybody I liked got killed off so fast I stopped reading), I suggest remembering the huge, swelling, joyful, outrageously loud and incredibly long ovation from the Belmont crowd as Victor Espinoza paraded the triumphant Pharoah all the way up to the head of the grandstand. That is not a sound I will ever forget. Joe Drape of the NYT called it a “roar from deep within their souls.” We souls who care for other souls felt ours resonate with theirs. Note: Dr. Barry practices Internal Medicine with Norton Community Medical Associates-Barret. She is a clinical associate professor at the University of Louisville School of Medicine, Department of Medicine.