<p><strong>In view of the increasing need for organ transplants( possibly because of the greater ability of the surgeons and physicians to both execute the transplant, prevent a rejection, and/or diagnose the need to transplant) how could one minimize the Type I statistical error (the possibility that while the patient is not brain dead he is diagnosed as such) when testing for brain death?</strong></p>

<p>It is a waste of resources to wait for metabolic death clinging to a life that cannot be saved thence omitting the duty to save people.</p>

<p>Nonetheless the duty to omit killing people actively/intently is even greater. This is exactly what we are doing when we remove the life support of someone in a chronic vegetative state( we will not go to jail only because at that time as medical standards mandate we wrongly assumed/believed they were brain dead, i.e We acted according to the medical standards but nonetheless came to a wrong conclusion/diagnosis).</p>

<p>Being a layman( I studied(partialy, uncomplete course) medicine aspiring to be a radiation oncologist and devote myself to proton therapy and carbon-ion radiation therapy for the brain probably due to my own PMA) I am absolutely terrified in the thought of being mistakenly diagnosed brain dead while being in vegetative state. I want my body to be useful even after I die I am just reluctant to sign up for organ donation because it might put even more stress on the already hectic life of physicians and increase the probability of a False Positive. Albeit being a cancer patient I could not even donate blood.</p>

<p>Therefore could a straight 48-hour or 72-hour recording of an EEG with as many non-redundant and carrefuly placed electrodes prove useful in reducing false positives? Is there a better alternative. Being a sufficient condition( or as close to it as possible) with the least necessary conditions.</p>

CC BY-SA 4.0
2020-01-10T22:49:13.120Z
I think you mean a Type I error: the null hypothesis is that the patient is alive. A Type I error would be concluding that someone is brain dead despite them being alive: a rejection of the null hypothesis when it should not be rejected. Also called a False Positive. Is there any evidence that the type I error rate for diagnosis of brain death is anything more than negligible using current methodology?
Bryan Krause
CC BY-SA 4.0
2020-01-10T23:14:36.603Z
And of course we want the probability of incorrectly determining death to be as small as possible, but you are asking about *reducing false positives*. If the false positive rate is already vanishingly low, there is no way to measure whether an intervention intended to reduce the false positive rate actually does so.
Bryan Krause
CC BY-SA 4.0
2020-01-10T23:46:43.577Z
@BryanKrause Probably having studied so many diverse things I got confused. First Economics then Medicine now Law. Regardless we could just interchange the null and the alternative in order to use the correct terminology. Forgive me for insisting on my error. If the null is brain death I am concerned with a false negative and if the null is not brain death I am concerned with a false positive.
George Ntoulos
CC BY-SA 4.0
2020-01-10T23:51:20.653Z
@BryanKrause The importance of theory is exactly that explaining and predicting. We theoretically; with a pencil and a paper, math models( chemical models, physicall models), thought experiments, can predict that if we do X and the result is Y then it is sufficient to conclude Z. Conditon Y is necessary to observe Z. If Z is true as a logical consequence Y must also be true. Therefore X is a good Test a good Criterion.
George Ntoulos
CC BY-SA 4.0
2020-01-11T00:27:36.250Z
False positive is correct for your situation. But a false positive is a type I error, not type II. So you are looking for "theory" to tell you how to reduce false positives in brain death? That's fine for developing a hypothesis, but then you have to test your hypothesis. You are asking in your question "Could doing X reduce false positives?" The only way to answer that is empirically, by doing an experiment. What I am telling you is that experiment is likely impossible.
Bryan Krause
CC BY-SA 4.0
2020-01-11T02:18:15.343Z
@BryanKrause i can only provide literature. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132575/
George Ntoulos
CC BY-SA 4.0
2020-01-11T03:03:21.493Z
That article does not talk about false positives in brain death determination. It is arguing whether "brain death" should be the standard for determining when a human is dead.
Bryan Krause
CC BY-SA 4.0
2020-01-13T00:47:40.690Z
@BryanKrause And this is to show that while it is nigh impossible to find evidence. If someone has their heart extracted they die regardless of being brain dead or not. The possibility of a false positive is extensively discussed.
George Ntoulos
CC BY-SA 4.0
2022-11-16T04:53:46.507Z
There was a lot of [news in 2010](https://www.nature.com/articles/news.2010.53) about doing this with fMRI.  According to [this review (2016)](https://umu.diva-portal.org/smash/get/diva2:936158/FULLTEXT01.pdf): "... studies have shown that misdiagnosis rates of disorders of consciousness can be as high as 40%."
Arnon Weinberg
<neuroscience><measurement><reference-request><methodology><eeg>
Whole brain death diagnosis and false positive
George Ntoulos
# Whole brain death diagnosis and false positive

(Asked by: username_0 on 2020-01-10)

**In view of the increasing need for organ transplants( possibly because of the greater ability of the surgeons and physicians to both execute the transplant, prevent a rejection, and/or diagnose the need to transplant) how could one minimize the Type I statistical error (the possibility that while the patient is not brain dead he is diagnosed as such) when testing for brain death?**

It is a waste of resources to wait for metabolic death clinging to a life that cannot be saved thence omitting the duty to save people.

Nonetheless the duty to omit killing people actively/intently is even greater. This is exactly what we are doing when we remove the life support of someone in a chronic vegetative state( we will not go to jail only because at that time as medical standards mandate we wrongly assumed/believed they were brain dead, i.e We acted according to the medical standards but nonetheless came to a wrong conclusion/diagnosis).

Being a layman( I studied(partialy, uncomplete course) medicine aspiring to be a radiation oncologist and devote myself to proton therapy and carbon-ion radiation therapy for the brain probably due to my own PMA) I am absolutely terrified in the thought of being mistakenly diagnosed brain dead while being in vegetative state. I want my body to be useful even after I die I am just reluctant to sign up for organ donation because it might put even more stress on the already hectic life of physicians and increase the probability of a False Positive. Albeit being a cancer patient I could not even donate blood.

Therefore could a straight 48-hour or 72-hour recording of an EEG with as many non-redundant and carrefuly placed electrodes prove useful in reducing false positives? Is there a better alternative. Being a sufficient condition( or as close to it as possible) with the least necessary conditions.

**Tags:** neuroscience, measurement, reference-request, methodology, eeg

> **Comments:**
> **username_1**: I think you mean a Type I error: the null hypothesis is that the patient is alive. A Type I error would be concluding that someone is brain dead despite them being alive: a rejection of the null hypothesis when it should not be rejected. Also called a False Positive. Is there any evidence that the type I error rate for diagnosis of brain death is anything more than negligible using current methodology?  
> **username_1**: And of course we want the probability of incorrectly determining death to be as small as possible, but you are asking about *reducing false positives*. If the false positive rate is already vanishingly low, there is no way to measure whether an intervention intended to reduce the false positive rate actually does so.  
> **username_0**: @BryanKrause Probably having studied so many diverse things I got confused. First Economics then Medicine now Law. Regardless we could just interchange the null and the alternative in order to use the correct terminology. Forgive me for insisting on my error. If the null is brain death I am concerned with a false negative and if the null is not brain death I am concerned with a false positive.  
> **username_0**: @BryanKrause The importance of theory is exactly that explaining and predicting. We theoretically; with a pencil and a paper, math models( chemical models, physicall models), thought experiments, can predict that if we do X and the result is Y then it is sufficient to conclude Z. Conditon Y is necessary to observe Z. If Z is true as a logical consequence Y must also be true. Therefore X is a good Test a good Criterion.  
> **username_1**: False positive is correct for your situation. But a false positive is a type I error, not type II. So you are looking for "theory" to tell you how to reduce false positives in brain death? That's fine for developing a hypothesis, but then you have to test your hypothesis. You are asking in your question "Could doing X reduce false positives?" The only way to answer that is empirically, by doing an experiment. What I am telling you is that experiment is likely impossible.  
> **username_0**: @BryanKrause i can only provide literature. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6132575/  
> **username_1**: That article does not talk about false positives in brain death determination. It is arguing whether "brain death" should be the standard for determining when a human is dead.  
> **username_0**: @BryanKrause And this is to show that while it is nigh impossible to find evidence. If someone has their heart extracted they die regardless of being brain dead or not. The possibility of a false positive is extensively discussed.  
> **username_2**: There was a lot of [news in 2010](https://www.nature.com/articles/news.2010.53) about doing this with fMRI.  According to [this review (2016)](https://umu.diva-portal.org/smash/get/diva2:936158/FULLTEXT01.pdf): "... studies have shown that misdiagnosis rates of disorders of consciousness can be as high as 40%."  

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## 0 answers

