Marathons and delayed diagnosis of MI; Collective diagnosis works for med students

robert bell rmsbell200 at YAHOO.COM
Fri Apr 14 00:42:03 UTC 2017


Mark, I am reminded of this with your second article.

It reminds me of a symposium I attended in Chicago in the early 90s where you had to rank the things that would save you and your passengers lives if your small plane crashed in the Arizona Desert and you had 15 items. 

Individually, you were asked to do the ranking and then with a group of 10 people. A survival expert then gave in great detail what he thought were the most important items. For nearly everyone in the room the groups were able to rank the list far, far better than most individuals. I remember that a mirror was pretty important, as a flashing mirror could be seen over the horizon.

I found this on line!  <http://electronicfieldtrip.org/caves/teachers/downloads/classroom-desertSurvival3.pdf>http://electronicfieldtrip.org/caves/teachers/downloads/classroom-desertSurvival3.pdf <http://electronicfieldtrip.org/caves/teachers/downloads/classroom-desertSurvival3.pdf>  

Desert Survival Expert Answers

Unless your team waited at the plane to be rescued you likely perished because of the heat and lack of water. The experts say these are the most important items.

1. mirror-signal planes with the reflected sunlight
2. top coat-protection from the sun and warmth at night 

3. water-may last 24 hour if you stay still
4. flashlight-a signal at night
5. parachute-visual signal for planes
6. pocket knife-cut cactus for water
7. raincoat-protection from sun and catch rain (unlikely) 

8. pistol-a noise signal

9. sunglasses-eye protection from sun

10. first aid kit- treat injuries

11. compass-useless if staying
12. map-useless if staying
13. book-you won’t starve
14. paint thinner- no use
15. salt-would only make you more thirsty 


> On Apr 13, 2017, at 2:12 PM, Mark Graber <mark.graber at IMPROVEDIAGNOSIS.ORG> wrote:
> 
> Two article of interest:
>  
> From our IOM-panel collaborator Bapu Jena:  Yet another reason for delayed diagnosis and sub-optimal outcomes that wasn’t on my list:  The marathon got in the way!
> http://www.nejm.org/doi/full/10.1056/NEJMsa1614073?query=TOC <http://www.nejm.org/doi/full/10.1056/NEJMsa1614073?query=TOC>
>  
>  
> And a study showing that ‘group’ diagnosis improved diagnostic accuracy by 20% on ER case scenarios, at least for medical students.  Would it work in practice?
> www.ncbi.nlm.nih.gov/pubmed/28355975 <http://www.ncbi.nlm.nih.gov/pubmed/28355975>
>  
> Mark
>  
> Mark L Graber MD FACP
> President, SIDM
> Senior Fellow, RTI International
> Professor Emeritus, Stony Brook University
>  
> 
> 
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