The VBAC Calculator Sucks

If chronic high blood pressure during the age range covered by the VBAC calculator is a polite code word for "not White" or "African American" by racist White assholes, maybe it's not actually useful data, medically speaking.

Do we have studies that meaningfully break down the influence of high blood pressure on this as separate from skin color? Or is it essentially a proxy for Black people? Or Black and Latina? Or Black, Latina and Native American?

That's from a different blog of mine called Witness to Destruction. That blog also has some posts about my opinions of high blood pressure in Black Americans:

Who do you trust?

Salt in the Wound 

Do a study and see if you can eliminate high blood pressure from this population. If high blood pressure is a proxy for "not White," eliminate that issue. That's probably the high road answer that doesn't require anyone to wonder if they are evil for being White or whatever.

I'm a BLOGGER. I'm dirt poor. I can cuss and be dramatic all I like.

If you work in healthcare, that's not the way to keep your job.

Currently, data from wearables is upending health insurance because the flood of data is rapidly changing the bets involved.

Basically, everyone in the for-profit medical industry already knows that if you collect enough data or your data changes, your bet changes. The VBAC calculator asks a short list of crappy questions and spits back a percentage -- a bet -- to help you decide what to do for your patient.

I'm well aware medicine gets called more art than science. I'm well aware it's full of risk assessment, like triage deciding who is more urgent when you have more patients than doctors.

But the VBAC calculator looks like a really stupid tool to me on the face of it because height and weight don't tell you much, as I rag on in the post linked above. 

I mean, hypothetically, they are calculating a quick and dirty answer to "How fat are you?" Height plus weight plus age don't really tell you that. That's the BMI -- Body Mass Index -- calculator and it doesn't distinguish a plump person from a body builder.

I've seen a piece that says metabolic syndrome that suggests fat is a risk for diabetes is wrong. It's more like a proxy for low muscle mass.

You can potentially check that. Find a muscular fatty population. Gather data.

Sumo wrestlers

Inuit

Lack of muscle mass causes insulin resistance.

I posted my source for that information to Hacker News years ago. The PDF used to be available publicly. It's possibly paywalled.

So the VBAC calculator spits back a percentage. It's placing a bet on the outcome. 

What you need is a tool saying:

"If she has high blood pressure, you do blah during vaginal delivery after c section." Or something like that.

Or if you are a Black nurse in an OB ward, you can check my hypothesis about what causes high blood pressure in your people and convince them to modify their diets and stop requiring medical treatment for high blood pressure.

And then you don't need to argue with an administrator about whether that's merely a proxy for skin color or if it's actually medically significant while he worries about legal liability and being sued and being unaccredited and blah blah blah.

Someone should come up with better tools than this crap. But if you have no choice but to use it, two can play that stupid game.

Solve the issue of high blood pressure in Black Americans and POLITELY tell the world to fuck off with its Jim Crow proxy with plausible deniability that your administrator isn't confident he can defend in court is stupid on the face of it and nothing we should bother with.