Do Age Cutoffs For Ventilator Allocation Favor Guideline Authors?

crispydocUncategorized

As part of an anticipated surge in COVID cases requiring ventilators, our hospital is preemptively preparing a framework to decide on ventilator allocation when demand exceeds supply.

In the course of researching the policy, I reviewed several papers on the subject, some of which advised using specific age cutoffs in determining who should receive a ventilator.

One paper in particular outlined the following age cutoffs in determining who should preferentially receive a ventilator, with younger age groups favored over older ones:

  • Age 0-49
  • Age 50-69
  • Age 70-84
  • Age >85

It led me the skeptic in me to wonder:Which of those age groups did the authors themselves fall into?

Put another way, might the authors of such a paper have succumbed to temptation to create age bands that favored their own inclusion?

I looked the authors up via doximity, an online network for medical professionals, and made the (admittedly flawed) assumption that each graduated medical school at age 26, which is the median age for a typical student who goes straight from high school to college to medical school.

Here are the age estimates I came up with:

Author #1: 45

Author #2: 71

Author #3: unable to verify

Author #4: 47

Author #5: 52

Author #6: 56

Author #7: unable to verify, suspect (at risk of offending) over 60

Author #8: 64

What does this thought process do for the cynic in me? It reassures me enough to know that those who chose these specific cutoffs have skin in the game. They might be placed into compassionate care so that another, younger patient at an earlier stage in the life cycle had the opportunity to receive a rationed ventilator.

Given that only two of the authors were slam dunk priorities to receive ventilators by their own criteria, I have that much more confidence in their recommendations.