International Journal of Physical Medicine and Rehabilitation, 2021
Cerebral palsy patients and their families need to predict patients’ length of survival for emoti... more Cerebral palsy patients and their families need to predict patients’ length of survival for emotional, medical, and financial planning reasons. Providing these estimations is wrought with challenges, some of which are specific to the significant variations in survival that are observed amongst this group of patients. The statistical models that are used to assess life expectancy are plagued by mathematical limitations, faulty assumptions, and the exclusion of factors that are critical to prognosis. In this commentary, we provide evidence that the medical community generally underestimates life expectancy in cerebral palsy. With medical innovations extending lives, some of the literature on life expectancy is outdated, but old data does not explain the extent of the discrepancies we see between what we observe in our communities and what is espoused in the literature. Herein, we offer potential explanations for these discrepancies and call on the medical community to improve predictions of survival in cerebral palsy patients so that they can get the care they need. The harms and dangers of biased life expectancy data cannot be overstated, and cerebral palsy patients are consistently living longer than the current literature would suggest. We demonstrate here why life expectancy models underestimate cerebral palsy survival in the community.
Craig Lichtblau1, Bernard Pettingill2*, Trish Cardillo3, Gabrielle Meli4 and Christopher Warburto... more Craig Lichtblau1, Bernard Pettingill2*, Trish Cardillo3, Gabrielle Meli4 and Christopher Warburton5 1Paley Orthopaedic and Spine Institute, St. Mary’s Hospital, West Palm Beach, Florida, USA 2LSU Medical Centre, New Orleans, LA 70112, USA 3Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA 4Cornell University, 219 Donlon Hall, Ithaca, New York 1583, USA 5University of Virginia, 301 15** Street N, West Charlottesville, Virginia 22903, USA *Corresponding author: Bernard Pettingill, PhD, Consulting Economist LSU Medical Centre, New Orleans, LA 70112, USA, Tel: 561-346-7828; E-mail: biffpett@gmail.com
Cerebral palsy patients and their families need to predict patients’ length of survival for emoti... more Cerebral palsy patients and their families need to predict patients’ length of survival for emotional, medical, and financial planning reasons. Providing these estimations is wrought with challenges, some of which are specific to the significant variations in survival that are observed amongst this group of patients. The statistical models that are used to assess life expectancy are plagued by mathematical limitations, faulty assumptions, and the exclusion of factors that are critical to prognosis. In this commentary, we provide evidence that the medical community generally underestimates life expectancy in cerebral palsy. With medical innovations extending lives, some of the literature on life expectancy is outdated, but old data does not explain the extent of the discrepancies we see between what we observe in our communities and what is espoused in the literature. Herein, we offer potential explanations for these discrepancies and call on the medical community to improve predicti...
International Journal of Physical Medicine and Rehabilitation, 2020
It is estimated that 80% of the population will experience lower back pain once in their lifetime... more It is estimated that 80% of the population will experience lower back pain once in their lifetime. Lower back pain with or without radiculopathy is frequently initially treated by family medicine, internal medicine or physical medicine and rehabilitation physicians and is the fifth most common reason for doctor visits nationwide. The most common culprit of lower back pain with radiculopathy is degeneration of the intervertebral space leading to disc disease and lumbar disc herniation (LDH).
Rotationplasty is a reconstructive option for severe congenital femoral deficiency (CFD). The sen... more Rotationplasty is a reconstructive option for severe congenital femoral deficiency (CFD). The senior author (D.P.) developed five new rotationplasty techniques for use in CFD based on the Paley classification, including the Paley–Brown (fusion femur to pelvis), Paley (fusion femur to femoral head), Paley–Winkelman (insertion tibial condyle to acetabulum), PaleySUPERhip–Van Nes (hip osteotomy with knee fusion) and PaleySling–Van Nes (hip reconstruction with knee fusion revision) rotationplasty techniques. The purpose of this study is to retrospectively evaluate the complications, radiographic outcomes and need for secondary surgery in 19 rotationplasty cases performed by the senior author (D.P.) for severe CFD from 2009 to 2019. Rotationplasty comprised only 2% of the authors treated CFD cases during this period. Average age at surgery was 8.6 years old. Average follow-up was 3.3 years. Sixteen concomitant procedures were performed including temporary arthrodesis, tibial osteotomy an...
International Journal of Physical Medicine and Rehabilitation, 2021
Cerebral palsy patients and their families need to predict patients’ length of survival for emoti... more Cerebral palsy patients and their families need to predict patients’ length of survival for emotional, medical, and financial planning reasons. Providing these estimations is wrought with challenges, some of which are specific to the significant variations in survival that are observed amongst this group of patients. The statistical models that are used to assess life expectancy are plagued by mathematical limitations, faulty assumptions, and the exclusion of factors that are critical to prognosis. In this commentary, we provide evidence that the medical community generally underestimates life expectancy in cerebral palsy. With medical innovations extending lives, some of the literature on life expectancy is outdated, but old data does not explain the extent of the discrepancies we see between what we observe in our communities and what is espoused in the literature. Herein, we offer potential explanations for these discrepancies and call on the medical community to improve predictions of survival in cerebral palsy patients so that they can get the care they need. The harms and dangers of biased life expectancy data cannot be overstated, and cerebral palsy patients are consistently living longer than the current literature would suggest. We demonstrate here why life expectancy models underestimate cerebral palsy survival in the community.
Craig Lichtblau1, Bernard Pettingill2*, Trish Cardillo3, Gabrielle Meli4 and Christopher Warburto... more Craig Lichtblau1, Bernard Pettingill2*, Trish Cardillo3, Gabrielle Meli4 and Christopher Warburton5 1Paley Orthopaedic and Spine Institute, St. Mary’s Hospital, West Palm Beach, Florida, USA 2LSU Medical Centre, New Orleans, LA 70112, USA 3Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida, USA 4Cornell University, 219 Donlon Hall, Ithaca, New York 1583, USA 5University of Virginia, 301 15** Street N, West Charlottesville, Virginia 22903, USA *Corresponding author: Bernard Pettingill, PhD, Consulting Economist LSU Medical Centre, New Orleans, LA 70112, USA, Tel: 561-346-7828; E-mail: biffpett@gmail.com
Cerebral palsy patients and their families need to predict patients’ length of survival for emoti... more Cerebral palsy patients and their families need to predict patients’ length of survival for emotional, medical, and financial planning reasons. Providing these estimations is wrought with challenges, some of which are specific to the significant variations in survival that are observed amongst this group of patients. The statistical models that are used to assess life expectancy are plagued by mathematical limitations, faulty assumptions, and the exclusion of factors that are critical to prognosis. In this commentary, we provide evidence that the medical community generally underestimates life expectancy in cerebral palsy. With medical innovations extending lives, some of the literature on life expectancy is outdated, but old data does not explain the extent of the discrepancies we see between what we observe in our communities and what is espoused in the literature. Herein, we offer potential explanations for these discrepancies and call on the medical community to improve predicti...
International Journal of Physical Medicine and Rehabilitation, 2020
It is estimated that 80% of the population will experience lower back pain once in their lifetime... more It is estimated that 80% of the population will experience lower back pain once in their lifetime. Lower back pain with or without radiculopathy is frequently initially treated by family medicine, internal medicine or physical medicine and rehabilitation physicians and is the fifth most common reason for doctor visits nationwide. The most common culprit of lower back pain with radiculopathy is degeneration of the intervertebral space leading to disc disease and lumbar disc herniation (LDH).
Rotationplasty is a reconstructive option for severe congenital femoral deficiency (CFD). The sen... more Rotationplasty is a reconstructive option for severe congenital femoral deficiency (CFD). The senior author (D.P.) developed five new rotationplasty techniques for use in CFD based on the Paley classification, including the Paley–Brown (fusion femur to pelvis), Paley (fusion femur to femoral head), Paley–Winkelman (insertion tibial condyle to acetabulum), PaleySUPERhip–Van Nes (hip osteotomy with knee fusion) and PaleySling–Van Nes (hip reconstruction with knee fusion revision) rotationplasty techniques. The purpose of this study is to retrospectively evaluate the complications, radiographic outcomes and need for secondary surgery in 19 rotationplasty cases performed by the senior author (D.P.) for severe CFD from 2009 to 2019. Rotationplasty comprised only 2% of the authors treated CFD cases during this period. Average age at surgery was 8.6 years old. Average follow-up was 3.3 years. Sixteen concomitant procedures were performed including temporary arthrodesis, tibial osteotomy an...
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