Crowd Wisdom for Diagnosis?

Hoffer, Edward P.,M.D. EHOFFER at PARTNERS.ORG
Wed Jul 17 18:01:08 UTC 2013


I would suggest hat rather than trust to serendipity - ie, someone on the list might have some useful ideas - that doctors with a puzzling case should avail themselves of computer-based clinical decision support systems such as DXplain (visit dxplain.net) or Isabel.  These have been well-proven to be useful in improving one's differential diagnosis.



Ed



Edward  P Hoffer MD

MGH Lab of Computer Science

________________________________
From: Peggy Zuckerman [peggyzuckerman at GMAIL.COM]
Sent: Wednesday, July 17, 2013 12:27 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: Crowd Wisdom for Diagnosis?

Dr. Zamir's suggestion that doctors who are puzzled by a diagnosis and turn to this or similar sites could solve some of the errors  that occur.  Frankly, I am more concerned about the doctor who has made a misdiagnosis, and has no idea that he has done so.

Thus the need for the patient to search out more input into the unresolved issue.  There is little information on the impact of misdiagnosis, but many in this community have personal experience with this.  Multiply that tenfold and you get a sense of the cost to our society.

A friend sums this up in the simple question that floats in the mind of every frustrated patient, "How do I know if my doctor knows what he is talking about?".

Peggy Z


On Wed, Jul 17, 2013 at 7:35 AM, Timothy Krohe <tkrohe1 at gmail.com<mailto:tkrohe1 at gmail.com>> wrote:

Agree with Dr Zamir the better utility of posting to physicians-only services .



While my goal is not to provide a plug,  this type of assistance happens regularly on sermo.com<http://sermo.com> .  In frequent posts,   a physician  describes a case,  requests help AND usually provides feedback to enhance learning. All posts are visible to all physicians, so there are glimpses of "how (other) doctors think".  Access is free to licensed physicians.  The website has MANY other humor/stress release/political/administrative postings as well so is not purely clinical and you need to sift for the clinically useful posts.



In the DoD, there is a worldwide teleconsult service that emails requests for help , often from the outlying combat or isolated bases. A large group of specialists/internists from the larger military hospitals have responsibility to respond quickly with comments/recommendations.   Very collegial and supportive for those docs/corpsmen/NPs/PAs providing care in isolated area. Access obviously limited to DoD.



I have enjoyed and learned (and I hope helped other MDs) from both systems.  No fees for the reqeuster in either.


TL Krohe MD General Internal Medicine




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