Erroneous laboratory results

Avrum H. Golub, M.D., J.D. avrum_h_golub_md_jd at ME.COM
Wed May 25 16:39:51 UTC 2016


Colleagues:
As board certified Pathologist and subspecialty certified Blood Banker, let alone as a J.D., I abhor the abbreviations used in this and other threads. Often, these abbreviations do not communicate.

Respectfully,
Avrum


Avrum H. Golub, M.D., J.D.
547 Asharoken Avenue
Asharoken, NY 11768-1121
(631) 651-2510
Mobile: (631) 759-1930
avrum_h_golub_md_jd at me.com
ahg_md_jd at me.com
NYS 116294


> On May 25, 2016, at 12:08 PM, Tom Benzoni <benzonit at GMAIL.COM> wrote:
> 
> 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 <mailto: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 <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 <tel:503%20502%205030> 
>   -:  Cameron at PhysicianCognition.com <mailto: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/>
> 
> <PhysicianCognitionLogo_email.png>
> 
>> On May 20, 2016, at 12:40 PM, DR WILLIAM CORCORAN <williamcorcoran at SBCGLOBAL.NET <mailto: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>
>>  
>>  
>>  <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 <tel:860-285-8779>
>> William.R.Corcoran at 1959.USNA.com <mailto:William.R.Corcoran at 1959.usna.com>
>> http://www.linkedin.com/in/williamcorcoranphdpe <http://www.linkedin.com/in/williamcorcoranphdpe>
>> https://www.box.com/shared/kfxg1lt9dh <https://www.box.com/shared/kfxg1lt9dh> 
>> 
>> 
>> 
>> On Friday, May 20, 2016 11:10 AM, Dwight Oxley <dwight.oxley at GMAIL.COM <mailto: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 <http://on.wsj.com/1TpKiL3>
>> 
>> 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 <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 <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/ <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 <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 <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/ <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 <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 <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/ <http://www.improvediagnosis.org/>
> 
> 
> 
> To unsubscribe from IMPROVEDX: click the following link:
> http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1 <http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1>
> 
> or send email to: 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/
> 







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


HTML Version:
URL: <../attachments/20160525/4a183b41/attachment.html>


More information about the Test mailing list