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One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
One percent rule
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One percent rule

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  • 1. 2/7/2013 gasabeh.com gasabeh47@gmail.com 1
  • 2. 2/7/2013 gasabeh.com gasabeh47@gmail.com 2
  • 3. (1% rule) 2/7/2013 gasabeh.com gasabeh47@gmail.com 3
  • 4. Aviation medicine (Safety---------------------factor-------------------------Risk) Flight safety Flight safety risk 2/7/2013 gasabeh.com gasabeh47@gmail.com 4
  • 5. 2/7/2013 gasabeh.com gasabeh47@gmail.com 5
  • 6. 2/7/2013 gasabeh.com gasabeh47@gmail.com 6
  • 7. 2/7/2013 gasabeh.com gasabeh47@gmail.com 7
  • 8. 2/7/2013 gasabeh.com gasabeh47@gmail.com 8
  • 9. 2/7/2013 gasabeh.com gasabeh47@gmail.com 9
  • 10. 2/7/2013 gasabeh.com gasabeh47@gmail.com 10
  • 11. 2/7/2013 gasabeh.com gasabeh47@gmail.com 11
  • 12. 1%rule is a example for risk management process (Retrospective) -Bad consequence in medicine :Mortality-Morbidity -Bad consequence in Aviation :Accident-Incident -Bad consequence in Aviation medicine : Pilot sudden medical incapacitation 2/7/2013 gasabeh.com gasabeh47@gmail.com 12
  • 13. History This "1 percent rule" began in the late 1980s and early 1990s in a series of British and then European aviation cardiology workshops. The application of this "1 percent rule" has subsequently spread beyond the domain of aviation cardiology to all potential causes of medical incapacitation. 2/7/2013 gasabeh.com gasabeh47@gmail.com 13
  • 14. Risk management process 1-Identify hazard& 2-Assess hazard: Epidemiological study -On average 1person mortality in 100000 population in one year or 10000 hours= 1/1000000000 (Risk Threshold) 2/7/2013 gasabeh.com gasabeh47@gmail.com 14
  • 15. Risk management process 3-Control of hazard A-If100 year flight B-10000 hour in one year Risk rate:1/1000000 1000 2/7/2013 gasabeh.com gasabeh47@gmail.com 15
  • 16. Risk management process 3-Control of hazard 2/7/2013 C-Incapacitation becomes critical only during landing or take-off, approximately 10% of an average one hour flight.(1/10) gasabeh.com gasabeh47@gmail.com 16
  • 17. 2/7/2013 gasabeh.com gasabeh47@gmail.com 17
  • 18. Risk management D-A simulator study indicated that subsequent to pilot incapacitation at a process critical part of the flight (takeoff and initial climb, approach and Landing the second pilot would take over successfully on 399 3-Control of occasions out of 400 such events hazard& (Chapman 1984). Taking this into account, 4- Implement it was assumed that a trained pilot should control be able to take over safely on 99 occasions out of 100 (Bennett 1988). 1/100 or (1%rule) Acceptable risk in two-pilot operations 2/7/2013 gasabeh.com gasabeh47@gmail.com 18
  • 19. DxCxBXA=Risk Threshold D=1/100(sudden incapacitation risk) C=1/10(Critical period) B=1/10000(one hour per one year) A=1/100(one year per one century) 1/100x1/10x1/10000x1/100=Risk Threshold 1/1000000000 2/7/2013 gasabeh.com gasabeh47@gmail.com 19
  • 20. Applying the one per cent rule The acceptable maximum incapacitation rate of one per cent per annum outlined above has become known as the “1% rule”. . This is widely regarded as an acceptable risk level and was adopted by the European Joint Aviation Authorities as the basis of aeromedical risk assessment. 2/7/2013 gasabeh.com gasabeh47@gmail.com 20
  • 21. Risk management process 5-Suprevie& Evaluate 1-Evidence-Based Medicine 2-Aeromedical Decision-Making 3- Medical Incapacitation Risk of Airline Pilots(Renal colic/Seizure/Pneumothorax) 4-Flight Safety(Medical-Environmental-Aircraft)in ICAO annexes-FAR(FAA)-JAR(JAA)-IATA 5-Flight Time(long haul:multizones/multisegments) 6-Aircraft automated/simulated 7-Number of pilots 8-Waivers 9-Controversy RISK LIMITS:1%, 2%, or 5% 2/7/2013 gasabeh.com gasabeh47@gmail.com 21
  • 22. 2/7/2013 gasabeh.com gasabeh47@gmail.com 22
  • 23. Systematic Review Definition A document often written by a panel that provides a comprehensive review of all relevant studies on a particular clinical or health-related topic/question. The systematic review is created after reviewing and combining all the information from both published and unpublished studies (focusing on clinical trials of similar treatments) and then summarizing the findings. Advantages Exhaustive review of the current literature and other sources (unpublished studies, ongoing research) Less costly to review prior studies than to create a new study Less time required than conducting a new study Results can be generalized and extrapolated into the general population more broadly than individual studies More reliable and accurate than individual studies Considered an evidence-based resource Disadvantages Very time-consuming May not be easy to combine studies 2/7/2013 gasabeh.com gasabeh47@gmail.com 23
  • 24. 2/7/2013 gasabeh.com gasabeh47@gmail.com 24
  • 25. 2/7/2013 gasabeh.com gasabeh47@gmail.com 25
  • 26. 2/7/2013 gasabeh.com gasabeh47@gmail.com 26
  • 27. 2/7/2013 gasabeh.com gasabeh47@gmail.com 27
  • 28. Ref: 1-Ernsting's Aviation Medicine-2006 2-Manual of Civil Aviation Medicine-2012 3-Joint Aviation Authorities -2009 4-Internet sources 5-Stuart J. Mitchell and Anthony D. Evans.Flight Safety and Medical Incapacitation Risk of Airline Pilots. Aviation, Space, and Environmental Medicine • Vol. 75, No. 3 • March 2004 6-Dougal B. Watson. Aeromedical Decision-Making: An Evidence-Based Risk Management Paradigm. Aviation, Space, and Environmental Medicine • Vol. 76, No. 1 • January 2005 2/7/2013 gasabeh.com gasabeh47@gmail.com 28
  • 29. 2/7/2013 gasabeh.com gasabeh47@gmail.com 29

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