Diagnostic Infrastructure

robert bell rmsbell200 at YAHOO.COM
Thu Feb 4 20:36:59 UTC 2016

To all on the list.

A friend kindly sent me this:  http://www.brookings.edu/blogs/techtank/posts/2016/01/11-open-access-scientific-knowledge <http://www.brookings.edu/blogs/techtank/posts/2016/01/11-open-access-scientific-knowledge>

It seems that much of the information that we see is obtained from Open Access information not from closed source Scientific Journals. Wikipedia editors are 47 percent more likely to use Open Source Journals for their information.

Consequently, the the public and probably also physicians are not getting the very best scientific information in a timely way.

This brings up the issue of what I will call the Diagnostic Medical Infrastructure.

If the infrastructure is not sound, information is not being distributed in the best way to physicians and the public to focus on evidence based medicine, physicians are missing a “raised" PSA test when someone has had a prostatectomy, and a large percentage of radiologists are missing an image of a "Gorilla” on an X-ray, and also a thousand and one other problems, particularly in the communication area, that in turn all lead to error, how can we hope to successfully first tackle diagnostic errors? 

If the current diagnostic error rate on all patients is say 30% would it not be better to get this figure down before focussing on improving diagnoses as a whole? It may be possible to tackle the standard errors and diagnostic errors together in some way but surely some of the standard errors have to be dealt with first to save lives and injury.  

Triaging some of these problems, correcting/improving them, could quickly start reducing the current diagnostic errors.

Should we first be focussing on the Diagnostic Medical Infrastructure?  

Should our focus first be on the best ways to save lives and stop patient injury?

Robert M. Bell, M.D.

Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine

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