Funtabulously Frivolous Friday Five 089

Relax it’s Friday!

Oh, you work shifts… never mind, another FFFF is here!

This week we find out how the Spanish health service intends to save 2 billion euros a year, what condition accounts for over 10 million courses of antibiotics each year in the US, and we learn about a clever Dutch physiologist, ego bias and micromorts.

Let’s dive on in…

Question 1

What new law was introduced in Spain in 2011, and is expected to save the Spanish health service over 2 billion euros a year?

  • Doctors were required to prescribe generic drugs whenever possible.
  • According to GaBI:

“The new law means that Spanish doctors will now have to complete prescriptions giving only the details of the active ingredients of the medicine, along with the dose and format. The pharmacist is then obliged to provide the cheapest available medicine, which will often be a generic drug rather than the more well-known brand-named version.”

  • Worth thinking about next time you write a prescription…

Question 2

According to the CDC, each year in the United States over 10 million courses of antibiotics are prescribed for what condition?

  • Upper respiratory tract infection (such as the common cold) caused by viruses
  • It goes without saying that these prescriptions are a waste of time for viral illnesses, which do not respond to antibiotics. But there is also the unnecessary cost, growing antibiotic resistance among bioflora and the exposure of patients to potentially life-threatening adverse effects.
  • This statistic was even worse before the CDC’s Get Smart campaign.

Question 3

What is ego bias?

  •  Ego bias is defined as systematic overestimation of the prognosis of one’s own patients compared with the expected outcome of a population of similar patients.
  • More senior physicians tend to be less optimistic and more reliable about patient’s prognosis, possibly reflecting reverse ego bias.

Poses RM, McClish DK, Bekes C, Scott WE, Morley JN. Ego bias, reverse egobias, and physicians’ prognostic. Crit Care Med. 1991 Dec;19(12):1533-9. PubMed PMID: 1959374.

Question 4

In 1903, which Dutch doctor-physiologist developed a string galvanometer to graphically record the changes in electrical potential during contractions of the heart?

  • Willem Einthoven (1860–1927)
  • Einthoven coined the term electrokardiogram (EKG) for his invention, which won him the Nobel Prize in 1924. His assignment of the letters P, Q, R, S and T to the various deflections is still used.
  • He is also known for these eponyms:

Einthoven’s law – In the ECG at any given instant the potential of any wave in lead 2 is equal to the sum of the potentials in lead I and III.

Einthoven’s triangle – an imaginary equilateral triangle with the heart at its centre, its equal sided representing the three standard limb leads of the electrocardiogram.

  • This is a quotation attributed to Einthoven:

“We should first endeavour to better understand the working of the heart in all its details, and the cause of a large variety of abnormalities. This will enable us, in a possibly still-distant future and based upon a clear insight and improved knowledge, to give relief to the suffering of our patients.”

Question 5

What is a micromort?

  •  A micromort is the risk out of a million of dying from a particular event.
  • As discussed in a great post on ScanCrit, they’re a useful way of quatifying the risk of different activities.
  • For instance:

Risk of a 50 year old dying from external cuases in normal daily living = 1 micromort
Scuba diving = 8 micromorts
100km motorcycle ride = 10 micromorts
Skydiving = 10 micromorts
Risk of of death from anesthesia during emergency surgery = 10 micromorts
Base jumping from Kjerag outside Stavanger in Norway = 430 micromorts
Climbing Everest = 12,000 micromorts per climb!

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Last week we defined funtabulous, this week — as gripping as this avalanche survival story is — we define ‘NOT funtabulous”:

Hat tip to the fantastic blog ScanCrit which featured this video in a must read post on Avalanche Survival.

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  1. says

    Hmmm, so those damn Yanks ARE correct when they shout about ‘getting an EKG’ even though they don’t talk about ‘referral to Kardiology’

    There was me thinking it was typical lazy spelling, rather than a nod to Einthoven.

    How quaint.