The Covid crisis has created huge waiting lists at Erasmus MC’s operating rooms. And deciding who gets helped first can be quite complicated. Surgeon Rob Baatenburg de Jong and researcher Hester Lingsma of Erasmus MC have developed a mathematical tool that can help physicians choose between candidates.

“This model is a decision tool,” clarified Baatenburg de Jong during an Erasmus TV broadcast. “It doesn’t decide anything itself – rather it helps us reach a decision.” Lingsma explained how the mathematical model calculated five variables. To start: the patient’s probability of survival before the procedure, followed by the patient’s probability of survival afterwards, his or her quality of life and the patient’s age. “By combining these five elements, the model can estimate which patient would benefit most from the planned procedure.”


Quality of life

Our poll among visitors in the hall of Erasmus MC yields a range of opinions on how best to clear the current waiting lists. “The doctors should simply start with the people who were at the top of the list before the crisis,” says Hella. Caroline, on the other hand, would prioritise patients who can expect to enjoy their new health longest after the procedure: “In other words, people who look forward to better quality of life after surgery.”

“The most important thing is that the attending physician makes this decision – no one else,” says Nelleke. She remains rather sceptical about relying on an algorithm. “I believe people are more than just their disease,” she continues. “The doctors need to take a very close look at how urgent the procedure is. And some people can mentally handle waiting better than others – even when, strictly speaking, their complaints may be more severe.”

Caroline: “A mathematical tool like this can definitely help, but it shouldn’t take over.”