Hi
 
I was present some years ago when a very friendly and highly respected
physician (now retired) was asking his team about frequency of symptoms in a
common disease. He told them they may be asked in a viva, for example, in
disease X, how many patients get symptom Y? If they thought it might be
common he said they should say 70%. They  probably would be at worst 20% or
so out, which the examiner would think was close enough. (They were more
likely to be asked about common than uncommon symptoms, but if they were
sure it was uncommon say 30%).
 
Regards, Steve
 
 

  _____  

From: Indovina, Joe [OCDUS] [mailto:[log in to unmask]] 
Sent: 13 July 2011 16:12
To: <a href="/cgi-bin/wa-jisc.exe?LOGON=A3%3Dind1107%26L%3DACB-CLIN-CHEM-GEN%26E%3D0%26P%3D5184932%26B%3D------_%253D_NextPart_001_01CC4174.86B28540%26T%3Dtext%252Fplain%26attachment%3Dq" target="_parent" >[log in to unmask]</a>
Subject: Re: The 70% thing





 

From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Dennis Huckerby
Sent: Wednesday, July 13, 2011 11:06 AM
To: <a href="/cgi-bin/wa-jisc.exe?LOGON=A3%3Dind1107%26L%3DACB-CLIN-CHEM-GEN%26E%3D0%26P%3D5184932%26B%3D------_%253D_NextPart_001_01CC4174.86B28540%26T%3Dtext%252Fplain%26attachment%3Dq" target="_parent" >[log in to unmask]</a>
Subject: Re: The 70% thing

 

Hi Mike

 

Thanks for the update attachment and all now becoming clearer about the
origination,  and use of the 70% figure. In case anybody is interested in
some of the stats available during the period of the Forsman 1996 paper,
(and if not press your delete button now) I attach some possibly relevant
tables from the market report Colin and I did for FT Healthcare during 1996
and 1997 which was then published in 1998 with the ISBN  number 1 85334
8686. To this attachment I would add the following notes -

 

1 -  a few years later when updated NHS figures became available we made an
attempt to calculate the % figure for 1996 to add to graph in Figure 2.3. We
expected this % to have increased but we ended up with a figure of slightly
less than 2% (as I indicated in an earlier email) and at the time we could
not find a reason why this had dropped. We then set it aside for further
investigation but that never transpired as another major project arose. Were
the NHS figures produced to a different basis? Did path costs really reduce
so much? Or did other healthcare costs rise to higher levels than expected??
We never found out - apols as it would have been an interesting finding.

 

2 - during our work on this market report, we made an number of attempts to
quantify the importance level of path tests to patient diagnosis and/or
treatment. Sadly the availability of useful figures was just not there in
those days and even though we had noted the Forsman paper (this was included
as a reference in our report) indicating 70%, the best we could do was to
make a supposition/subjective estimate of not more than 50%. But I do stress
that was in 1996 before the major cash increases in health care input by the
Blair government and I also have to stress it was before litigation became a
serious aspect for clinicians and management to consider when diagnosing and
treating patients. It was also before GPs were targeted/bonused on their
management of specific diseases and I would hastily add that I am not
suggesting that the acquiring of bonuses was a major decision point for GPs
requesting path tests but having to focus on specific diseases encouraged
them to be more aware of their needs for more positive diagnoses and so
consider the benefit in requesting more path specific tests

 

I think I will close now before I get myself into further trouble

 

Hope some of this information is of interest to some of you and I would
agree with your thoughts Mike that the 70% claim is " quietly
buried"........................Dennis

 

From: Clinical biochemistry discussion list
[mailto:[log in to unmask]] On Behalf Of Hallworth Mike (RLZ)
Sent: 12 July 2011 13:42
To: <a href="/cgi-bin/wa-jisc.exe?LOGON=A3%3Dind1107%26L%3DACB-CLIN-CHEM-GEN%26E%3D0%26P%3D5184932%26B%3D------_%253D_NextPart_001_01CC4174.86B28540%26T%3Dtext%252Fplain%26attachment%3Dq" target="_parent" >[log in to unmask]</a>
Subject: Re: The 70% thing

 

Hi all - as promised, here is my summary of the (limited) evidence behind
the various 70% claims. I've summarised it in an attachment to spare those
who are already bored with this thread!

Happy to update it if anyone has anything further to add. 

Mike 

<<70%.doc>> 

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