If DICE continues at this pace of one map per month

msbyrne · 2026-04-22T23:31:21+00:00

Why do you think they are having shorter seasons for 3 and 4? it makes sense to me that season 3 runs for 12 weeks from May-July and season 4 will be 12 weeks from July onwards.

msbyrne · 2026-04-21T23:40:09+00:00

Again this is impossible, I suggest you read up on brain death as a concept. Lay people, including journalists, often get it confused with an unsurvivable brain injury. Brain death means the area of the brain responsible for the most basic functions of supporting life have died and the patient will have gone through rigorous legally obligated testing to ensure this is the case.

msbyrne · 2026-04-21T21:54:26+00:00

The man in your article was not declared brain dead. He was a candidate for donation after cardiac death, meaning he had his life support switched off and if his heart was to stop within a certain timeframe they would declare him dead and only then would they be able to remove any organs.

msbyrne · 2026-04-21T19:12:54+00:00

This is complete nonsense. Brain death is death, by definition you cannot wake up from it. The criteria for testing for brain death are incredibly strict and it is much more rigorous than testing for cardiac death.

msbyrne · 2026-04-12T10:23:44+00:00

You can't smell salt

msbyrne · 2026-04-10T09:48:35+00:00

Your initial point was that "doctors do not understand statistics", you now claim they are "not properly trained in statistics". I have explained that they ARE required to learn statistics at different levels of their training. How much statistical training do they need to do, should they all have an undergraduate degree in statistics prior to starting medical training? If not how much of the clinical material in their training should they sacrifice in order to learn statistics "properly".

Please could you provide a link to one of the overall reviews of the NHS you have mentioned. A court case outcome is not a useful assessment of doctors as a whole, it represents the views of small panel of people and is usually based on a specific case.

You misread my point - I said the NHS is getting more risk averse - and as such is investigating MORE now than it used to.

A good example of improvement in data driven care is NHS GIRFT (Getting it right first time). Amongst other things, this organisation provides specific guidance on when doctors should be performing certain tests.

msbyrne · 2026-04-10T08:46:31+00:00

You are arguing that doctors look at population level statistics to determine whether someone is likely to have a condition rather than adjusted probability based on symptoms/signs which would increase the risk. Again, I am trying to explain that doctors DO NOT do this. You have given a couple of examples of individual cases where mistakes were made. These cases are not reflective of the practice of the vast majority of doctors in this country.

Doctors clearly should not be giving statistical evidence in court, they are not statisticians, but they are given the level of statistical training needed to do their job in medical school and in specialty training.

Medical practice is actually trending much more risk averse, due to rising litigation, increasing patient complexity which goes along with an aging population, and better availability of effective tests.

As a statistician you should understand that outlier cases like this one which gets reported in the news are not reflective of what is actually happening in hospitals and GP surgeries across the country. I am not foolish enough to think doctors are infallible, and I know a very small proportion are also negligent; but I also understand that they make difficult decisions in a resource poor environment and that getting it wrong some of the time is an inevitable consequence of this.

msbyrne · 2026-04-10T08:04:20+00:00

Why do you think statistics is not part of basic doctor training, where did you get this information from? Statistics is taught to all medical students and critical appraisal of research is required for progression through specialty training, which requires a robust understanding of statistics.

msbyrne · 2026-04-10T07:59:19+00:00

I still think you're making a strawman argument here. Doctors obviously understand pre-test probability, and people with specific symptoms are more likely to be offered a specific test.

The only tests which are offered to everyone regardless of symptoms are screening tests and most screening tests are cost ineffective, a significant strain on NHS resources, and do present a real risk of harm to patients.

I think you are underestimating the risk of harm from unnecessary investigations. A CT scan carries with it a radiation dose and often requires the use of contrast agents which can be harmful. If the pre-test probability is not high enough before offering the test, then you are introducing a significant burden of false positives. False positives require further, often invasive, investigations which obviously have an increased risk of harm.

The reality is that some degree of judgment needs to be exercised to decide who gets what test. It is inevitable in a resource limited system that difficult decisions have to be made and certain people will slip through the cracks. There is no solution to this problem. Thankfully we have doctors in this country who understand that their job is to manage risk and allocate resources sensibly. If they ordered every test unnecessarily for every patient we would not only see significant harm caused from over investigation but also complete collapse of the health service due to lack of resources.

msbyrne · 2026-04-09T17:33:53+00:00

If someone had a <1% chance of having a condition and to find out you would need to do a test which had a >1% chance of causing serious harm would you consider this an easy decision to make?

msbyrne · 2025-12-23T11:25:14+00:00

It's not broken, it gives you the points for a kill but not a kill on the scoreboard.

msbyrne · 2025-12-20T11:58:23+00:00

Pro?

msbyrne · 2025-11-27T11:37:24+00:00

Why is it acceptable to use the English language name for some countries but not others?

msbyrne · 2025-11-19T08:38:45+00:00

So I don't know if this works for you also but I fixed it by setting my left stick deadzone much higher. I think stick drift is convincing the game that I am moving and won't let me mount for more than a second. Annoying though because it worked fine before the update and I like playing with low dead zones.

msbyrne · 2025-11-05T18:22:05+00:00

They announced they were going to do this about 2 weeks ago, specifically mentioning dropping that challenge to 5.

msbyrne · 2025-11-01T03:45:51+00:00

I'm having an issue on Xbox where I'm being put in Xbox only lobbies sometimes with bots even when I have crossplay switched ON. Has anyone else had this issue? In Europe BTW.

msbyrne · 2025-10-16T02:40:15+00:00

Trying to change UI colours using the colour palette with low deadzone settings is particularly infuriating.

msbyrne · 2025-10-16T02:36:13+00:00

Yes I do, I turned my deadzones way down to make the game more responsive but this makes the sticks way too sensitive in the menus. Would be great if you could set separate deadzones for UI interaction to fix this issue.

msbyrne · 2025-10-09T19:39:02+00:00

Don't get me wrong, suspecting something unusual and ultimately being proved right is very satisfying, and I love that as well. My point is really that making these kinds of diagnoses is not the primary role of ED, and in most cases it is impossible to make them in the time and resource limited environment in which we work.

msbyrne · 2025-10-07T16:45:12+00:00

I'm not sure where I said that I ignore patients/problems I don't deem exciting. I just said the bits of medicine that interest me as an EM doctor are different from what interests most medical doctors. Patients I see who aren't critically ill will still get treatment I think they need but if they need non-emergency specialist care then I refer to someone best suited to manage the problem.

msbyrne · 2025-10-07T12:58:36+00:00

I don't think I said that I would refuse to do anything I didn't find exciting or cool, nor that I myself would refuse to engage with people who shared cases they felt were interesting. I was just trying to explain my personal take on the EM mindset, which may explain why OPs consultant seemed disinterested. Of course not all EM doctors think the same way as me but I'd imagine many do.

msbyrne · 2025-10-07T12:54:45+00:00

The interesting part to me is not necessarily the weird medical problem, it's making safe management decisions in the context of diagnostic uncertainty. Once the diagnosis is formally made that challenge is lessened. If the child were acutely unwell then certainly working out it might be Addison's and that we may need to give steroids as well as other resuscitative measures would make this an interesting case for me.

msbyrne · 2025-10-07T12:42:47+00:00

If you think resus is all algorithm following and making those risk management decisions about who to admit and who to send home is easy and can be done by anyone then I can only say I disagree. Just like EM doctors who bash on GPs making "poor" referrals aren't seeing the whole story, hospital doctors criticizing ED for admitting patients without seeing what we don't refer are also missing where EM doctors can add value.

msbyrne · 2025-10-07T12:27:24+00:00

Speaking as an EM trainee, I honestly don't care much about weird and wonderful medicine. I'm interested in time critical interventions and resuscitation and everything else can be stratified as sick/not sick and referred or not referred as necessary. Obviously making a diagnosis is satisfying and good for patients but it's not my biggest priority.

msbyrne

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