[EXTERNAL] [IMPROVEDX] What comes first

robert bell rmsbell200 at YAHOO.COM
Tue Mar 14 03:28:09 UTC 2017


Seems to be a massive problem for medicine.

How big a problem is that for IMPROVEDX?

How to tackle it?

What is the impact, if any, on accurate diagnoses?

Rob Bell, MD
> On Mar 13, 2017, at 4:44 PM, Edward Winslow <edbjwinslow at GMAIL.COM> wrote:
> 
> Close on Guidelines, but it is worse than we might expect. In November 2015 The National Guideline Clearing House claimed that there were:
> 486 guidelines for "Hypertension"
> 517 guidelines for "Heart Failure"
> and "only" 129 for "Atrial Fibrillation"
> There is certainly guideline bloat. We had hoped, I think, that the Coordinating Committee for Comparative Effectiveness Research would help clarify what worked and what was adding little. This group will be abolished by the American Health Care Plan.
> 
> I posted on this topic about a year and a bit ago. If you want, I can direct you to the post.
> 
> 
> 
> 
> On Mon, Mar 13, 2017 at 3:19 PM, Samuel, Rana <Rana.Samuel at va.gov <mailto:Rana.Samuel at va.gov>> wrote:
> The place to start would be by tidying up the guidelines themselves. What credibility do guidelines have when multiple differing guidelines exist on a topic? I believe someone on this listserve mentioned earlier that there were 6 guidelines on Atrial fibrillation, and they all had differing recommendations!
> 
> First set the standard, then promote / facilitate use of the standard!
> 
> Rana
> 
> Rana Samuel, MD, FCAP
> Chief, Pathology and Laboratory Medicine Service (PALMS, 113)
> Lead pathologist - VISN 2
> VA western New York Healthcare System (VAWNYHS)
> 3495 Bailey Avenue, Buffalo, NY 14215
> Ph:    716-862-8701 <tel:716-862-8701>
> Fax:  716-862-7824 <tel:716-862-7824>
> Rana.samuel at va.gov <mailto:Rana.samuel at va.gov>
> 
> -----Original Message-----
> From: Robert Bell [mailto:0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG <mailto:0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG>]
> Sent: Monday, March 13, 2017 11:55 AM
> To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG <mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
> Subject: [EXTERNAL] [IMPROVEDX] What comes first
> 
> Could I add one big item to my list to tidy up medicine, and that is the number of medical guidelines not followed by so many HCPs.
> 
> It reminds me of doing surgery today without a sterile environment as was done in the 1800s. As we learn should we not change? Does the guideline field need studying? Do computers need to remind us of critical aspects of a guideline. What is a critical aspect?
> 
> Rob Bell, MD
> 
> Sent from my iPad
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> 
> 
> -- 
> Edward B, J. Winslow, MD, MBA
> Home 847 256-2475; Mobile 847 508-1442
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> 
> "The only thing new in the world is the history that you don't know"
>        Harry S. Truman, 33rd President of US (1945-1953)
>   
> 
> "... it can be argued that underinvestment in assessing the past is likely to
> lead to faulty estimates and erroneous prescriptions for future action."
>         Eli Ginzberg, 1997
> 
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Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


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