Personalized Anesthesia for the Elderly
The elderly patient population is increasing over time and they require more surgical interventions. In order to provide a safe and effective anesthesia we must recognize the age related issues and needs and tailor a personalized anesthesia plan that not
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Personalized Medicine in Anesthesia, Pain and Perioperative Medicine
Ali Dabbagh Editor
Personalized Medicine in Anesthesia, Pain and Perioperative Medicine
Editor Ali Dabbagh Cardiac Anesthesiology Department Anesthesiology Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
ISBN 978-3-030-53524-7 ISBN 978-3-030-53525-4 (eBook) https://doi.org/10.1007/978-3-030-53525-4 © Springer Nature Switzerland AG 2021 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication. Neither the publisher nor the authors or the editors give a warranty, expressed or implied, with respect to the material contained herein or for any errors or omissions that may have been made. The publisher remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. This Springer imprint is published by the registered company Springer Nature Switzerland AG The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Preface
As anesthesiologists, we need to help predict the risk for individual patients for specific surgeries and/or procedures. Although these physicians are aware of randomized clinical studies that suggest specific outcomes for those individual patients, there are some very important problems with the clinical studies that are available. What needs to be remembered is that the “use of evidence from clinical trials to support decisions for individuals” is a form of “reference class forecasting”: implicit predictions for an individual are made on the basis of outcomes in a reference class of “similar” patients treated with alternative therapies. Yet, often patients are excluded because they have a low event rate or for other reasons—making the study population unlike the patients we care for. The goal of personalized medicine is to narrow the reference class so that the patients studied are more similar to the patients we care for. This is clearly not the case in multiple clinical trials, where patients of different ages with multiple problems are compared to those who have no or few problems. It appears that even our randomized clinical trials truly lack the ability to predict outcomes for many of ou
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