Erroneous laboratory results

Avrum H. Golub, M.D., J.D. avrum_h_golub_md_jd at ME.COM
Wed May 25 21:20:43 UTC 2016


And, I equally abhor the pressure practitioners face from patients influenced by various advertising methods - what does ED meant you? PE?
A

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


> On May 25, 2016, at 12:39 PM, Avrum H. Golub, M.D., J.D. <avrum_h_golub_md_jd at me.com> wrote:
> 
> 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 <mailto: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 <mailto: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>
>>> 
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>> 
>> 
>> 
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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