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Life Expectancy - Dr Mark Burgin

20/08/19. Dr. Mark Burgin BM BCh (oxon) MRCGP explains a methodology for Life reports as the 16th disability area based upon mathematical calculations.

Life expectancy can be calculated with far more accuracy than in previous decades due to the increasing data and risk models available to the assessor.

The number of days that a Life will lose or gain due to changes in risk factors can be calculated to the number of days compared with months and years previously.

This level of accuracy brings problems as minor health issues which were considered de minimis are now enough to change the values.

Generalists find understanding ‘nature and severity’ easier than specialists who do not routinely manage the disease and are unfamiliar with the patterns.

Basic Life

The ONS life tables have been the basis of Life reports since they were first written and remain the standard approach before modifications.

The tables are relatively easy to use and can predict the average life expectancy from previous trends so their reliability will fall with longer time scales.

They also cannot predict the effects of changes in risk factors that occur rapidly even if they affect the whole population.

Health problems that impact the area where the person lives again will not be included in these figures as they are averaged across the whole country.

Personal modifiers

Many diseases can influence the Life and knowledge of the natural history can indicate the nature and severity of these influences.

Where the disease is common in the population it must be remembered that the Basic Life will already include an allowance for that disease.

Disability analysis can be used to look for personal modifiers that have not been diagnosed formally but are causing functional restrictions.

Occasionally it will be required to ask the Life to undergo testing to rule out or in a particular complication which would change the expert’s opinion.

Risk modifiers

The individual’s risk will be modified against the population in general by factors such as lifestyle and family history and calculators such as QRISK3 cardiovascular risk can be useful.

Review of the medical records can identify many of these factors and there are methodologies to calculate their likely influence on the basic Life.

A cardiac risk of 30% over the next 10 years is the same level as a patient who needs surgery with a severe or several mild coronary vessels narrowing.

Cancer risks should be considered separately as the risk factors vary between different types and an individual can have a high chance of one with low risks to others.

Conclusion

Calculating Life expectancy requires a good mathematical ability as applying modifiers can be complex as the correct methodology must be applied.

Recent advances have allowed accuracy to improve so even small changes in Life expectancy can now be assessed for example ‘loss of a chance’ in late cancer diagnosis.

Although medical records based Life expectancy is still commonplace the gold standard Life report is based upon a disability analysis examination.

The good news for solicitors is because the situations where these reports are required is increasing the cost of individual Life reports is falling.

Doctor Mark Burgin, BM BCh (oxon) MRCGP is on the General Practitioner Specialist Register.

Dr. Burgin can be contacted This email address is being protected from spambots. You need JavaScript enabled to view it. and 0845 331 3304 website drmarkburgin.co.uk

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