2 articles of interest - Are more heads better than one?

Bob Latino blatino at RELIABILITY.COM
Mon Mar 4 12:38:48 UTC 2019


Thought this may be of interest to this group:)

Facts Don't Change People's Minds. Here's What Does
https://heleo.com/facts-dont-change-peoples-minds-heres/16242/

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From: Applegate, Kimberly E [mailto:keapple at UKY.EDU]
Sent: Monday, March 04, 2019 6:47 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] 2 articles of interest - Are more heads better than one?


Good afternoon,

I enjoy this discussion as it brings up all the potential implementation science pitfalls. Yet, it is not an 'all or none' proposal to double read imaging in these medical professions (radiology, and also cardiology, dermatology, pathology). I am quite confident that we have the (be it artificial) intelligence to design appropriate processes that select the most important and problematic in our interpretative areas that will benefit our patients. So, why not do it?



I will add that in some countries, to deal with the insufficient number of radiologists, they simply do not interpret (or bill for) any plain radiographs (Japan). That decreases the work load a great deal and they have one of the best WHO health and longevity ranks in the world...I would urge us to think out of the box.

Kimberly



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From: Mark Gusack <gusackm at COMCAST.NET<mailto:gusackm at COMCAST.NET>>
Sent: Sunday, March 3, 2019 5:29 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: Re: [IMPROVEDX] 2 articles of interest - Are more heads better than one?


Good Afternoon Everyone:



I agree that double reading is very valuable.  We do it all the time in Surgical and Cytopathology.  However, the devil is in the details.  The double read has to occur under circumstances that assures both do an independent read to avoid bias.  In addition, it has to be structured so the 'ball' isn't dropped because each figures the other will get it if they don't.  Finally, there has to be a way of resolving differences of 'opinion' that avoids confrontation and provides as means of a 'third party' expert being available to confirm one, or the other, or neither diagnosis.



Mark Gusack, M.D.

President

MANX Enterprises, Ltd.

304 521-1980

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From: Bruno, Michael <mbruno at PENNSTATEHEALTH.PSU.EDU<mailto:mbruno at PENNSTATEHEALTH.PSU.EDU>>
Sent: Sunday, March 3, 2019 2:55 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: Re: [IMPROVEDX] 2 articles of interest - Are more heads better than one?



Yes, that was a fantastic paper!!  I think your data suggest that the potential value of double reading could be as much as 12X for error reduction.  I cited it on p3 of the attached paper from the December, 2018 issue of the journal Radiology.



Mike





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From: Applegate, Kimberly E <keapple at UKY.EDU<mailto:keapple at UKY.EDU>>
Sent: Sunday, March 3, 2019 7:15 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: Re: [IMPROVEDX] 2 articles of interest - Are more heads better than one?



Thank you--in some countries double radiology interpretations are required (e.g., Sweden) and we might find addition evidence for value of collective intelligence.



As one proxy measure for error,  we looked at the addenda rate in radiology reports and noted fewer addenda when a radiology resident had co-interpreted with us. Many hypothesized just the opposite. This suggests that 2 pair of eyes serves our patients better than one pair. AI may do the same to augment our abilities. Parenthetically, women radiologists were more likely to perform addenda than men. This leads to further social science questions.

Kimberly Applegate, MD, MS



https://www.ajronline.org/doi/pdf/10.2214/AJR.17.18339<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttps-3A__www.ajronline.org_doi_pdf_10.2214_AJR.17.18339%26d%3DDwMFAw%26c%3D_FmMnDvUH5queZcSmOuBzHZMbp7E7EwtGwv5cxxnTj0%26r%3DXZJky8Jx0OuETXcWpBMhx9j_wSYpSZPDVXdInJ5O9gQ%26m%3DEAMFtePHzo6ZQgbZ2v0FJz3flNDZXves7yjGtviYQoE%26s%3Dyu-WCLXEYbV95mPkkhipwS-7GWgPwOQRgaQsNXUoitM%26e%3D&data=02%7C01%7Ckeapple%40UKY.EDU%7C6c4cf3d100db4812bc3d08d6a05244a5%7C2b30530b69b64457b818481cb53d42ae%7C0%7C1%7C636872672544462378&sdata=%2FT6TAllQx87xkRivgScnyGI1DxAwC%2F2HzLEGGcnuOjM%3D&reserved=0>



Trainees May Add Value to Patient FOCUS ON: Care by Decreasing Addendum Utilization in Radiology Reports - ajronline.org<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttps-3A__www.ajronline.org_doi_pdf_10.2214_AJR.17.18339%26d%3DDwMFAw%26c%3D_FmMnDvUH5queZcSmOuBzHZMbp7E7EwtGwv5cxxnTj0%26r%3DXZJky8Jx0OuETXcWpBMhx9j_wSYpSZPDVXdInJ5O9gQ%26m%3DEAMFtePHzo6ZQgbZ2v0FJz3flNDZXves7yjGtviYQoE%26s%3Dyu-WCLXEYbV95mPkkhipwS-7GWgPwOQRgaQsNXUoitM%26e%3D&data=02%7C01%7Ckeapple%40UKY.EDU%7C6c4cf3d100db4812bc3d08d6a05244a5%7C2b30530b69b64457b818481cb53d42ae%7C0%7C1%7C636872672544462378&sdata=%2FT6TAllQx87xkRivgScnyGI1DxAwC%2F2HzLEGGcnuOjM%3D&reserved=0>

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976 AJR:209, November 2017 patient care decisions [6]. To correct or ex-pand on a previously finalized report, radi-ologists must generate an addendum to the




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From: David L Meyers <dm0015 at COMCAST.NET<mailto:dm0015 at COMCAST.NET>>
Sent: Saturday, March 2, 2019 1:08 PM
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Subject: [IMPROVEDX] 2 articles of interest - Are more heads better than one?



An interesting article and editorial comment, just published, relevant to improving diagnosis:



https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2726708?guestAccessKey=1856b32c-88c6-4eda-912e-9717b95a5807&utm_source=silverchair&utm_campaign=jama_network&utm_content=weekly_highlights&cmp=1&utm_medium=email<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttps-3A__na01.safelinks.protection.outlook.com_-3Furl-3Dhttps-253A-252F-252Fjamanetwork.com-252Fjournals-252Fjamanetworkopen-252Ffullarticle-252F2726708-253FguestAccessKey-253D1856b32c-2D88c6-2D4eda-2D912e-2D9717b95a5807-2526utm-5Fsource-253Dsilverchair-2526utm-5Fcampaign-253Djama-5Fnetwork-2526utm-5Fcontent-253Dweekly-5Fhighlights-2526cmp-253D1-2526utm-5Fmedium-253Demail-26data-3D02-257C01-257Ckeapple-2540UKY.EDU-257Cbab531af97f5430f1c1208d69f3a26ef-257C2b30530b69b64457b818481cb53d42ae-257C0-257C1-257C636871469444760085-26sdata-3DoAzpxiki519EpecFrku1fTD9Qi2ayKDa-252B-252FO0ERf6lsU-253D-26reserved-3D0%26d%3DDwMFAw%26c%3D_FmMnDvUH5queZcSmOuBzHZMbp7E7EwtGwv5cxxnTj0%26r%3DXZJky8Jx0OuETXcWpBMhx9j_wSYpSZPDVXdInJ5O9gQ%26m%3DEAMFtePHzo6ZQgbZ2v0FJz3flNDZXves7yjGtviYQoE%26s%3DerI_D95U1zanI2cyIcizWb9rWaavDu72ezoj3uttdDg%26e%3D&data=02%7C01%7Ckeapple%40UKY.EDU%7C6c4cf3d100db4812bc3d08d6a05244a5%7C2b30530b69b64457b818481cb53d42ae%7C0%7C1%7C636872672544482388&sdata=XIDsjGunpEzl33DoGbrWcsElIcL4%2Bf8XQmeUAnZ66ag%3D&reserved=0>



https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2726709?guestAccessKey=464bc45c-77b0-442b-993e-c1e91e784773&utm_source=silverchair&utm_campaign=jama_network&utm_content=weekly_highlights&cmp=1&utm_medium=email<https://na01.safelinks.protection.outlook.com/?url=https%3A%2F%2Furldefense.proofpoint.com%2Fv2%2Furl%3Fu%3Dhttps-3A__na01.safelinks.protection.outlook.com_-3Furl-3Dhttps-253A-252F-252Fjamanetwork.com-252Fjournals-252Fjamanetworkopen-252Ffullarticle-252F2726709-253FguestAccessKey-253D464bc45c-2D77b0-2D442b-2D993e-2Dc1e91e784773-2526utm-5Fsource-253Dsilverchair-2526utm-5Fcampaign-253Djama-5Fnetwork-2526utm-5Fcontent-253Dweekly-5Fhighlights-2526cmp-253D1-2526utm-5Fmedium-253Demail-26data-3D02-257C01-257Ckeapple-2540UKY.EDU-257Cbab531af97f5430f1c1208d69f3a26ef-257C2b30530b69b64457b818481cb53d42ae-257C0-257C1-257C636871469444770094-26sdata-3D69SDOVELd8-252FeKKnm-252F1YC-252FViGj1Hcf2fMkdXn3xYBBFs-253D-26reserved-3D0%26d%3DDwMFAw%26c%3D_FmMnDvUH5queZcSmOuBzHZMbp7E7EwtGwv5cxxnTj0%26r%3DXZJky8Jx0OuETXcWpBMhx9j_wSYpSZPDVXdInJ5O9gQ%26m%3DEAMFtePHzo6ZQgbZ2v0FJz3flNDZXves7yjGtviYQoE%26s%3DlQkKez--1HANf6ODFFrUQ77U4kq3DKZNXc9yIBhSkek%26e%3D&data=02%7C01%7Ckeapple%40UKY.EDU%7C6c4cf3d100db4812bc3d08d6a05244a5%7C2b30530b69b64457b818481cb53d42ae%7C0%7C1%7C636872672544482388&sdata=fE14R%2FHz1X3wDG%2F4aMMLHrfTJUIKGfgf9syjHM5dTjg%3D&reserved=0>





David

David L Meyers, MD FACEP

Society to Improve Diagnosis in Medicine

Listserv Moderator/Board member

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


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