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The QDeath Algorithm

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In a call centre, somewhere in Milton Keynes

Hello, you're through to Defying Expectation And Timing Health. You're speaking to Richard.

Right, you filled out one of our online questionnaires and would like to talk through your options. 

Can I just confirm that there have been no deaths before the age of 65 in any first degree relatives or deaths from inheritable conditions in any first or second degree relatives? Excellent, thank you, those tend to skew our data.

OK, let’s process your data and feed it into our QDeath algorithm.

[A pause]

OK, that's interesting. Based on your social class, occupation, previous history of smoking, your chance of the big three are pretty much even. So what that means is that you pretty much have the same chance of dying from a cardiovascular cause, cancer or dementia. Looking at population trends, drug and technology advances, the confidence intervals on the stroke and heart attack data are the widest. 

What does that mean? Well it means that, those are the ones that are hardest to predict. Yes, I know, frustrating isn't it?

Now I see you completed the supplementary questions and that under no circumstances do you want to die from dementia? If we try to lower your dementia risk and work the calculation backwards then we can see what you need to do from now.

Right. As there is a negative correlation between dementia and smoking, and smoking is correlated to both cardiovascular disease and cancer we would suggest that you start smoking 20 cigarettes a day straight away. 

Can we predict what type of cancer? No, sorry. We haven't got that type of granularity yet.

What if you have a stroke that doesn't kill you but just incapacitates you? Well that is a risk, sir. As is having a non-fatal heart attack resulting in end-stage heart failure. To increase your chances of a fatal cardiovascular event I would suggest that you stop exercising, drink over the recommended limit of alcohol, put on weight and never have your cholesterol or blood pressure measured. You may also want to consider a prolonged course of drugs associated with a sudden cardiac death, such as domperidone or citalopram, or even high dose methadone. Preferably a combination.

The other issue is that by starting smoking you bring in respiratory causes of death. So, you may end up with chronic lung disease, disabling breathlessness and frequent chest infections. 

OK. What I will do is put all of this in an email to you, for you to have a think over and discuss with your loved ones. My name is Richard and if there is anything else we can do to help then don't hesitate to call us back at Defying Expectation And Timing Health.

You're welcome. Thank you for your call.

Dr Samir Dawlatly is a GP in Birmingham

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