Erroneous laboratory results

Tom Benzoni benzonit at GMAIL.COM
Wed May 25 16:08:35 UTC 2016


I'm a "thin" lab tester and 90% of what I order I don't need.
My junior confreres order easily double my volume.
Same outcomes narrowly defined; fully defined, worse outcomes.
(I don't order d-dimer on patients without at least moderate likelihood PEs
or DVT. My junior guys do so routinely and so do many more CTA and U/S. We
have the same rate of final diagnoses. But I (likely) have fewer renal
failures (we don't see followup) and fewer bankruptcies.

Take, for example, ABGs. They are rarely needed; the same data is available
venously and from already done tests (BMP/MGA/SMA7), pulse ox and EtCO2,
yet I see 40% of our ICU tests are ABG.
CBC with diff when most folks can't interpret the diff but don't know they
can't. CBC without diff when you only need the Hgb.
EKG in my shop is an excellent predictor that you do NOT have ACS.
All LPs go to IR.

I could go on.

So overtesting is huge.

tom benzoni

On Wed, May 25, 2016 at 10:20 AM, Cameron Powell <
cameron at physiciancognition.com> wrote:

> Perhaps some of you have already seen this study on under- and
> over-testing.
>
> “First we found that the rate of overuse, meaning [medical laboratory]
> tests that we performed that shouldn’t have been performed, average around
> 20%. That means out of every 10 tests ordered about two tests on average
> should not have been ordered.
>
> “Even more surprising was the rate of underuse [of medical laboratory
> tests]. This is the rate of tests that should have been ordered in a given
> time but weren’t ordered. That rate was over 40%. So, for every three tests
> performed, an additional two tests should have been ordered.”
>
> http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0078962
>
> We’ve taken a run at solving suboptimal testing strategies and it’s going
> very well. We’ll keep you posted on our progress.
>
> Cameron
>
>
>
> Teaching Mode is Here! (Android
> <https://play.google.com/store/apps/details?id=com.physiciancognition.xebrapro>
>  | IOS <https://itunes.apple.com/us/app/xebra-pro/id1051676634>),
>
>
> *Cameron Powell  |  *CEO, Physician Cognition, Inc.
>   ———————————————————————
>   (:  503 502 5030
>   -:  Cameron at PhysicianCognition.com <Cameron at physiciancognition.com>
>   ::   PhysicianCognition.com <http://physiciancognition.com>
>  Watch Xebra Pro in action! <Https://youtu.be/D_ZZPYbA6Q8>
>   Follow On:
>    Twitter - Company <https://twitter.com/PhysicianCog>
>    Twitter - Personal <http://www.twitter.com/cameroncpowell>
> Facebook <https://www.facebook.com/Physician-Cognition-1542884199311822/>
>
>
> On May 20, 2016, at 12:40 PM, DR WILLIAM CORCORAN <
> williamcorcoran at SBCGLOBAL.NET <williamcorcoran at sbcglobal.net>> wrote:
>
> What do you think of the YouTube video and the comments posted?
>
> WSJ journalist John Carreyrou shares year-long Theranos investigation &
> breaks latest, stunning news <https://youtu.be/zSgwJA-GOlg>
>
>
> [image: image] <https://youtu.be/zSgwJA-GOlg>
>
>
>
>
>
> WSJ journalist John Carreyrou shares year-long Theranos ...
> <https://youtu.be/zSgwJA-GOlg>
> View on youtu.be <https://youtu.be/zSgwJA-GOlg>
> Preview by Yahoo
>
>
>
> Take care,
>
> Bill Corcoran
>
>
> William  R. Corcoran, Ph.D., P.E.
> 21 Broadleaf Circle
> Windsor, CT 06095-1634
> 860-285-8779
> William.R.Corcoran at 1959.USNA.com <William.R.Corcoran at 1959.usna.com>
> http://www.linkedin.com/in/williamcorcoranphdpe
> https://www.box.com/shared/kfxg1lt9dh
>
>
>
> On Friday, May 20, 2016 11:10 AM, Dwight Oxley <dwight.oxley at GMAIL.COM
> <dwight.oxley at gmail.com>> wrote:
>
>
>
> The link below details how a large number of erroneous results were
> reported from a commercial medical laboratory. This report is just the
> latest in the Wall Street Journal’s coverage of the Theranos Co. Lab
> results account for more than 50% of the information in a medical record,
> thus the impact of these is enormous.
>
> Dwight Oxley
>
>
> http://on.wsj.com/1TpKiL3
>
> ------------------------------
>
> <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
> <IMPROVEDX-SIGNOFF-REQUEST at list.improvediagnosis.org>
>
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in
> Medicine
>
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/
>
>
>
> ------------------------------
>
> <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
> <IMPROVEDX-SIGNOFF-REQUEST at list.improvediagnosis.org>
>
>
>
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in
> Medicine
>
> To learn more about SIDM visit:
> http://www.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
>
> Moderator:David Meyers, Board Member, Society for Improving Diagnosis in
> Medicine
>
> To learn more about SIDM visit:
> http://www.improvediagnosis.org/






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


HTML Version:
URL: <../attachments/20160525/5edcdf24/attachment.html> ATTACHMENT:
Name: PhysicianCognitionLogo_email.png Type: image/png Size: 3718 bytes Desc: not available URL: <../attachments/20160525/5edcdf24/attachment.png>


More information about the Test mailing list