One of the implicit characteristics of commandments clustered in 10s is
that they are general, high-level principles.
Numbers 3 and 10 (unlike the rest) are too detailed and (in the case of
PDAs) have consistent evidence suggesting they are wrong or (in the case
of relational database software) are transparently unfeasible.
Cheers!
Jim
James M. Walker, MD, FACP
Chief Medical Information Officer
Geisinger Health System
The best way to predict the future is to invent it.
- Alan Kay
>>> Ash Paul 04/12/12 1:12 PM >>>
Dear Rakesh,
Your comment 'Is it possible that most practitioners would love to
understand EIP as (B) practice informed on the cumulation/totality of
research but unfortunately often end up with (A) practice informed by
any piece (or pieces) of evidence' is not only very interesting but also
very relevant, especially for healthcare commissioners.
You might find this 2009 article published in the 'Journal of Health
Sceinces Education' interesting:Educational strategies to reduce
diagnostic error: can you teach the stuff?
http://www.isabelhealthcare.com/pdf/EducationStrategiesToReduceDiagnosticError.pdf
The author Mark Graber refers to (here we go again, I'm wading into
Biblical controversy once more!) The 10 Commandments To Reduce Cognitive
Errors1. Thou shalt reflect on how you think and decide.
2. Thou shalt not rely on your memory when making critical decisions.
3. Thou shalt make your working environment information-friendly by
using the latest wireless technology such as the Tablet PC and PDA.
4. Thou shalt consider other possibilities even though you are sure of
your first diagnosis.
5. Thou shalt know Bayesian probability and the epidemiology of the
diseases in your differential diagnosis.
6. Thou shalt mentally rehearse common and serious conditions that you
expect to see in your specialty.7. Thou shalt ask yourself if you are
the right person to make the final decision or a specialist after
considering the patient’s values and wishes.
8. Thou shalt take time to decide and not be pressured by anyone.
9. Thou shalt create accountability procedures and follow up for
decisions made.
10. Thou shalt record in a relational data base software your patient’s
problems and decisions for review and improvement.
Leo Leonidas MD (Pediatrics, Maine)
Ref: Medical Teacher, 30,
Trowbridge, R. (2008). Twelve tips for teaching avoidance of diagnostic
errors.
496–500.
Regards,
Ash
>________________________________
>From: Rakesh Biswas
>To: [log in to unmask]
>Sent: Thursday, 12 April 2012, 15:34
>Subject: Re: Definitions of EBM/EBP
>
>
>Thanks Neil for this great discussion.
>
>Is it possible that most practitioners would love to understand EIP as
(B) practice informed on the cumulation/totality of research but
unfortunately often end up with (A) practice informed by any piece (or
pieces) of evidence.
>
>This is again possibly due to the fact that cumulation/totality of
research depends on 'as far as such cumulation exists' and is accessible
to the practitioner?
>
>regards, rakesh
>
>
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