The Brady Bunch? New evidence for nominative determinism in patients’ health: retrospective, population based cohort study
BMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f6627 (Published 12 December 2013) Cite this as: BMJ 2013;347:f6627All rapid responses
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I would like to congratulate Keaney and his colleagues that decided to tackle the important issue of nominative determinism in patients’ health.
I believe that another reasonable explanation for their findings might be that of natural selection.
According to this theory it is plausible that the Brady bunch's surname might have alerted care givers to suspect the existence of an asymptomatic and lethal arrhythmia and to further investigate and closely follow these patients. This in turn, has improved the chances of the Bradys to survive and breed. The process of the "survival of the Bradys" has thus contributed to the study's results.
Based on this theory, I believe that physicians must be aware of this possible clinical "selection bias" and avoid any underestimation of disease in patients with counterintuitive names (this phenomenon warrants further in-depth research).
Competing interests: In the creation-evolution debate, I stand with evolution.
In Keaney and colleagues' fascinating article, one possible explanation other than nominative determinism of health status has not been mentioned.
Pacemaker insertion is the final step in a series of medical actions, many potentially cue-dependent - including for example, the thorough investigation of the frequently vague and intermittent symptoms of bradycardia and/or the decision to request a cardiology review. Is it possible that a patient is more likely to be referred appropriately for a pacemaker if the letters BRADY appear at the top of every page of his notes?
Competing interests: No competing interests
Until I packed up Anaesthesia recently, I often found myself working with an orthopod, Mr Cutts.
Regards
Will Notcutt.
PS A Dr Nutt took over from me.
Make of that what you will.
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One physician at my previous hospital of employment was named Dr. Docktor.
I would be interested in seeing if this phenomenon is present in South Korea with their limited variety of surnames...
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Over the years and across many hospitals ( all in the US) - I have noticed that if the patient is named "Destiny" they are more likely to have nasty forms of encephalopathy irrespective of etiology - I always consider it a independent adverse risk factor when consulting on these kids !!
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Professor Lamabadusuriya and Dr Fernandopulle are two eminent paediatricians with whom I have worked with. The words 'lama' and 'pulle' means 'child' in Sinhalese and Tamil languages (the two spoken in Sri Lanka)respectively.
Dr Paranavithana was an eminent archaeologist in Sri Lanka. The word 'Parana' means old or ancient in Sinhalese.
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When I was growing up, I went to an ophthalmology group comprised of Drs. Snow and Fogg. Yes, they were real!
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I have noticed for some time that Foyle Hospice patients feel better after consultations with my colleague Dr Hope.
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Not only Weedon and Splatt !
I remember many urology papers by Professor Smellie and Dr Leakey.
And Prof Beardwell taught me endocrinology.
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Re: The Brady Bunch? New evidence for nominative determinism in patients’ health: retrospective, population based cohort study
I think Dearbhaile O'Donnell may have something in the preferential diagnosis according to the patient's (or doctor's) name.
Another possibility is confirmation bias. Did the Brady bunch have the highest incidence of Bradycardia or were there other names, perhaps Birchall or O'Donnell, with even greater susceptibility to this diagnosis?
What would have been the significance of that? Probably no more, or less, than the significance of the incidence in the Bradys. Their incidence was not average and perhaps it was remarkable enough to warrant examination and publication in a Xmas issue of BMJ but perhaps not exceptional enough to warrant further research without a more sceptical critique by an independent statistician?
Competing interests: No competing interests