Thursday, February 27, 2014

A Proposal for Assessing the Severity of Medical Conditions

When visiting a doctor, which is something I seem to do a lot more often now that we have small children, I am struck by how often one is asked to quantify things using ill-defined scales or metrics. Most frequently a doctor or nurse will ask you to quantify pain or discomfort on a scale from one to ten. Now a person like me(*) will react by first wondering if this is a linear or a logarithmic scale? Then I wonder what it is it's actually measuring? Is it, for example, the total number of nociceptors firing, or some other measure of brain activity.

Eventually I'm forced to conclude that the scale is in fact an arbitrary judgement, similar to the scoring system for Olympic figure skating, which then begs the question of whether pain should receive a different score if, say, it's inflicted by a Russian or a Korean athlete.

Of course figuring all this out distracts from the task at hand.

In order to avoid such confusion, I'm proposing that the medical community adopts a system of scales based upon more tangible concepts, such as, say, living organisms. If using organisms the comparative values can take into account a variety of factors such as complexity, position on the food chain, and, most importantly, coolness.

For example, a particularly nasty virus has recently been working it's way around my household and I was the last member of my family to succumb. A few days ago, when my wife asked me how I was feeling, I said that on a scale from Amoeba to Bengal Tiger,  I rated as a sea slug. I then went back to bed for the remainder of the morning. 

The following day I felt much better and rated myself, on the same scale, as a pygmy tree shrew. (The highest I seem to be able to get on this particular scale is about Aardvark, before some new blight is bought home from pre-school).

Of course it is quite possible to vary these scales in order to get a more accurate response from the patient. For example if a patient had an interest in architecture, one could ask them to use a scale from porta-potty to The Great Pyramids of Giza, while a chef might use a scale from cheez-wizz  to Piedmontese white truffles. Some experimentation may be necessary in order find the optimal scale for each individual.

(*) I also feel that cheese should be ordered by volume, while my local cheesemongers want me to order by weight and do not seem to be aware of the density of individual cheeses. I've found that the best compromise to this problem is to order by specifying the angle to be cut from a wheel of cheese, which leaves the problem of whether to use degrees or radians.