Thursday, September 20, 2007

Success story: death of a quality measure

There's a perspective piece in the New England Journal of Medicine this week (subscription required for full-text access) discussing a healthcare quality success story.

This brief piece looks at the use of beta-blockers in the acute period after myocardial infarction - how this was operationalized as a quality measure by the National Committee for Quality Assurance (NCQA) in 1996 and why this measure is being retired as a quality indicator. Dr Lee notes:
Good research seems to be necessary but not sufficient to create sweeping
change for the better. What are the other key ingredients? The beta-blocker
story helps us to flesh out the recipe.

A great quick overview of an example of how strong evidence from clinical research was translated to a pervasive change in the US healthcare system.

Reference: Lee TH. Eulogy for a quality measure. New Engl J Med 2007 Sept 20;357(12):1175-1177.

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Tuesday, September 04, 2007

Errata reporting

I get the JAMA table of contents by email each week, and noticed today that they've started including more detail about the corrections. This week's errata, for example:

Incorrect Data and Omission of Trial Site and Personnel in: Effects of Tamoxifen vs Raloxifene on the Risk of Developing Invasive Breast Cancer and Other Disease Outcomes: The NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 Trial JAMA 2007;298 973

Incorrect Data and Wording in: Patient-Reported Symptoms and Quality of
Life During Treatment With Tamoxifen or Raloxifene for Breast Cancer
Prevention: The NSABP Study of Tamoxifen and Raloxifene (STAR) P-2 Trial
JAMA 2007;298 973

Incorrect Data in Tables in: Nonvalidation of Reported Genetic Risk Factors
for Acute Coronary Syndrome in a Large-Scale Replication Study JAMA 2007;298 973
A small change but seems so much more informative about the nature of the problem, rather than just noting that an error was made and making you go to the full-text to figure out how "big" the error was.

Monday, September 03, 2007

NLM and Harry Potter

The National Library of Medicine currently has an exhibition exploring medicine and medical history in the Harry Potter books - Do Mandrakes Really Scream? Magic and Medicine in Harry Potter.
There is more to the Harry Potter series than a child hero or a fantasy adventure —many of the characters, plants, and creatures in Rowling’s stories are based in history, medicine, or magical lore. Death, evil, illness, and injury affect the characters of Harry Potter’s imaginary world. In describing their experiences, Ms. Rowling has drawn on important works of alchemy and herbology. These works and other links to Harry Potter books are examined in this exhibition.

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