On the fallacy of labs

HM Epstein hmepstein at GMAIL.COM
Fri May 10 12:55:25 UTC 2019


Hi Mark,
I recall your poster. In your email you noted “issues with CPRS as well as resistance from both laboratorians and clinicians.” Can you elaborate? 
Best,
Helene

On May 9, 2019, at 5:12 PM, Mark Gusack <gusackm at comcast.net> wrote:

Excellent Question Rob.
 
I’ve been fighting for this since I was a Nuclear Medicine Technologist back in the early 1970’s doing RIA studies on a scintillation instrument that basically generated…random test results.
 
So, I tried to implement this in large academic medical centers, small hosptials (with some minor successes), and reference laboratories.  Finally, after being at the VA for seven years  I had some success as a member of the National Diabetes Work Group with Dr. Pogash at VACO.  That was in 2011.  I was the technical consultant in laboratory and statistical analysis and developed a method of using quality control data for our Tosoh HbA1c instrument to generate accuracy and precision information which we were able to publish within the comments section of each test with links in CPRS to additional explanation and graphic presentation of what the data meant.  The idea was to roll this out to the rest of the VA.  Unfortunately, it wasn’t feasible due to issues with CPRS as well as resistance from both laboratorians and clinicians.  So, that was stopped.  The underlying idea was to use HbA11c as a testbed for applying this concept to create risk control information for all major diagnostic tests.
 
You can see the poster I presented at a past DEM conferences at:
 
http://www.manxenterprises.com/manxwebsite/homepage/manxposters_htm_files/demposter2013-acceptableriskmeasuringa1c.pdf
http://www.manxenterprises.com/manxwebsite/homepage/manxposters_htm_files/demposter2017-presentinglaboratorytestresults.pdf
 
Have a good day.
 
Mark
 
Mark Gusack, M.D.
President
MANX Enterprises, Ltd.
304 521-1980
www.manxenterprises.com
 
 
From: Robert Bell <0000000296e45ec4-dmarc-request at LIST.IMPROVEDIAGNOSIS.ORG> 
Sent: Thursday, May 9, 2019 4:12 PM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
Subject: Re: [IMPROVEDX] On the fallacy of labs
 
Would accuracy rankings on all tests reported help by promoting research to improve the test, and also lead to fewer errors in diagnosis?
 
Rob Bell, M.D.
 

Sent from my iPhone

On May 9, 2019, at 9:48 AM, Edward Hoffer <ehoffer at gmail.com> wrote:

https://www.whatswrongwithhealthcareinamerica.com/2019/03/my-last-doctor-said-i-had-lupus.html
  
Edward P Hoffer MD
Associate Professor of Medicine, part-time, Harvard
Treasurer, SIDM
 


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