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In a message dated 99-07-18 09:02:34 EDT, someone wrote: > I am also interested in this discussion regarding liability of EBM > particularly as Tobly Lipman refers to an example of the > interpretation of radiological findings. Recently attempts have been > made to define and establish what is an acceptable standard by which > to judge the performance of others when interpreting plain films. This > has been done so in the context of potential cases of litigation The following material discusses a software approach to medical records-making that provides avenues for incorporating "evidence-based" citations, references and supporting docu- mentations into any description about any patient transaction. While the functions did arise in radiology,they do not address the "errors and variations" between the interpretations of individuals. They do bear directly on the ability of any single physician to correct his or her own procedural and diagnostic errors as "based on evidence" held in a system's memory. One user of the system cut his diagnostic errors by fifty percent as he generated report transscipts carrying specific (or evidence- based) citations from the literature for selected observations and judgements. Thank you. Karl Dockray "On a teaching/practice ware that can record, message, and manage any kind of information now put on paper with alpha-numeric signals...a does-anything ware that can run in lap tops up to integrated systems. It is proposed that an integrated clinical software, in continuous development since 1984, might be able to help with the teaching and distibution/broadcast of instructional fact.The software joins all of the five major processes of medical informatics such as the making, storing, and messaging of any data element now put on paper plus the review and analysis of information to help decision support and qualitative research. If the "generic" techniques are of interest, call or e-mail KT Dockray [log in to unmask] (USA) 1 806 763 5775 for a 6 pp pre-print titled "Differing Ideas About Softwares for Medicine and Management" . The paper sketches how five critical informatic processes were integrated to make a general information utility. Then, strategies for electronic teaching address such questions as why students of both medicine and management should learn to touch-type in an integrated software from their first days of training...how students can record lecture notes in their own machines, manage electronic teaching materials given to them on discs...or retrieve data from the internet... how educators can put reliable structure into their teaching by titling each subject presented with the symbolic abbrev- iations, acronyms, mnemonics and eponyms already used in day-to-day clinical work...and why teachers should give specific citations showing where the supporting data for each concept taught can be found in paper or electronic archives. There are also some strategies showing how a student's or resident's use of learned fact can be tested, tracked and graded electron- ically...and how apprentices of both medicine and management can machine-record their earliest clinical experiences, carry their databases into practice and use them to do better work. A version of the utilities can be downloaded from Medical Edu- cation On-Line at http://www.utmb.edu/meo. Select the subject "Educational Resources" at the home page's left margin and scroll to the end of the file for STAT*WRITER. Expect six MGB of DOS code that is WIN 3.1, '95, '98, WIN2000-NT and Y2K compatible. %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%