Researchers want a better system for fixing bad science | The Verge

Bruno, Michael mbruno at HMC.PSU.EDU
Thu Feb 11 15:14:58 UTC 2016


I agree.  Nothing beats direct observation.  Everything else is at least potentially subject to the (so-called) flaw of averages*.

Mike

_____
   * Savage, Sam L.  The Flaw of Averages.  New Jersey: Wiley & Sons, 2009  ISBN 978-0-471-381976


From: Elias Peter [mailto:pheski69 at GMAIL.COM]
Sent: Wednesday, February 10, 2016 4:45 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] Researchers want a better system for fixing bad science | The Verge

" I kept daily lists of the errors and worked with the Risk Managers to resolve.”

If I had a magic wand, I would require that all hospitals create a group of 'safety observers’ that would include patients, provide some training in systems and medical care, and then pay them to sit and observe and take notes and report regularly (monthly at least) to administration/risk management and involved departments to identify, prioritize, and address safety issues.

I think there is a simple logic to this: direct observation of process by independent individuals with different perspectives will see and find things that no fancy internal risk management system will see.

Peter Elias, MD

On 2016.02.09, at 7:50 AM, Bob Latino <blatino at RELIABILITY.COM<mailto:blatino at RELIABILITY.COM>> wrote:


The U.S. spends ~17% of its GDP on Healthcare or about $3 Trillion/yr (or ($9,323/person).  It is hard to believe we do not throw enough money at it.  It is how we use the monies so inefficiently and ineffectively that is the problem.  For all of the money thrown at HC, our mortality rates as compared to the rest of the world do not demonstrate ours was money well spent.  Why not?



To put this into perspective France and Switzerland spend 11% of their GDP on healthcare.  The Middle East spends much less (see below).



<image003.png>


Source: https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/highlights.pdf
Source: https://www.cia.gov/library/publications/the-world-factbook/rankorder/2066rank.html
Definition: The crude death rate is the number of deaths occurring among the population of a given geographical area during a given year, per 1,000 mid-year total population of the given geographical area during the same year.



Because the manner in which death rates are collected, deaths due to 'medical' error are not uniformly collected or collected at all in many countries.  So the only uniform measure of death is called the 'crude death rate' around the world (see definition above).  Deaths due solely to medical error are included however, the split (%) is not discernible.  Regardless, when you look at the investment in HC as opposed to GDP, and overall crude death rate/1000 total population, the numbers are varied and quite startling.  Why do these countries with the lowest investment in HC as a % of their GDP, also have the lowest crude death rates in the world?



I know there are many researchers on this forum who will chew this up and explain to us the reasons; but as a layman, I am interested in learning why.



Irrespective of what the studies in the link Rob provided conclude, just sitting in any hospital for a day and observing, one can make a list of errors for themselves.  To me, it is hard to imagine a hospital stay without an error occurring the course of the delivery of care.  Both of my parents passed in the last 9 years and both were in ICU's for 2 - 4 weeks.  We stayed with them 24/7 during those stays.  I kept daily lists of the errors and worked with the Risk Managers to resolve.  I know what I am looking for, just think of those who do not and just 'trust' their care givers and their delivery of care systems. Are they told of these errors?



I believe Rob's point is not that the errors are not occurring, but what is the scope and magnitude of them?  How do we accurately identify, quantify and prioritize them so we can focus on solving them in a logical manner?  How do we do this in a fashion where actions replace words and change can be observable in the near term (instead of during our lifetime)?  Certainly there are more complex issues that will take longer to resolve but I believe the 80/20 applies here as well.  I suspect that 20% or less of the error types (Failure Modes we call them in my business) account for 80% or more of the total occurrences.  Certainly we can act on this 'low hanging fruit' in the 20% range (or what we call the Significant Few).



Bob Latino





Robert J. Latino, CEO

Reliability Center, Inc.

1.800.457.0645

blatino at reliability.com<mailto:blatino at reliability.com>

www.reliability.com<http://www.reliability.com>





-----Original Message-----
From: Robert Bell [mailto:0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG]
Sent: Monday, February 08, 2016 10:09 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: [IMPROVEDX] Researchers want a better system for fixing bad science | The Verge



http://www.theverge.com/2016/2/3/10897938/science-correction-process-problems-report-university-alabama



This supoports the concept that the diagnostic infrastructure is overall in a bad state. Is money the big problem - too much or too little?



Rob Bell

Sent from my iPad

To unsubscribe from the IMPROVEDX:

mail to:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG<mailto:SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>

or click the following link: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>



Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>



For additional information and subscription commands, visit:

http://www.lsoft.com/resources/faq.asp#4A



http://LIST.IMPROVEDIAGNOSIS.ORG/<http://list.improvediagnosis.org/> (with your password)



Visit the searchable archives or adjust your subscription at:

http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX



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



To unsubscribe from the IMPROVEDX list, click the following link:<br> <a href="http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1" target="_blank">http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1</a<http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1%3c/a>>

</p>

________________________________

Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>

To unsubscribe from IMPROVEDX: click the following link:
http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1

or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>

Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX


Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine

To learn more about SIDM visit:
http://www.improvediagnosis.org/



________________________________

Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>

To unsubscribe from IMPROVEDX: click the following link:
http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1
or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>

Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX

Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine

To learn more about SIDM visit:
http://www.improvediagnosis.org/

To unsubscribe from the IMPROVEDX:
mail to:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG
or click the following link: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG

Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG

For additional information and subscription commands, visit:
http://www.lsoft.com/resources/faq.asp#4A

http://LIST.IMPROVEDIAGNOSIS.ORG/ (with your password)

Visit the searchable archives or adjust your subscription at:
http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX

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

To unsubscribe from the IMPROVEDX list, click the following link:<br>
<a href="http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1" target="_blank">http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1</a>
</p>

HTML Version:
URL: <../attachments/20160211/40f45c54/attachment.html>


More information about the Test mailing list