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Bias in the ER

nautil.us

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Re: Bias in the ER

#21

Post by stonesixone »

chimeracoder wrote: post #14
spqr0a1 wrote: post #10

Earlier quoted context omitted.

Unfortunately, just being metal isn't enough. Most metal surfaces in hospitals are stainless steel, which can hold viable pathogens for a week or more. Silver plating would sterilize some pathogens in as little as 5 minutes.

> Silver plating would sterilize some pathogens in as little as 5 minutes That would be very expensive for very little benefit - five minutes is more than long enough for multiple people to use the same buttons at a busy hospital during the day. It's much better to promote behaviors like washing hands before touching food or mucous membranes (like rubbing your eyes) and using alcohol-based hand sanitizers when that i…

> In addition, never touch those buttons with the tips of your fingers. Use the knuckle of your pinky instead

Combining suggestions above, perhaps touching it with a ring on your finger would be even better (e.g. a silver ring).

Re: Bias in the ER

#23

Post by jimmaswell »

nerdponx wrote: post #15
Hasz wrote: post #11

They hadn’t bothered to consider statistically far more likely causes of an irregular heartbeat. In Redelmeier’s experience, doctors did not think statistically. Statistics assumes independence, something that may be hard to come by in the ER. Even when you start factoring in the covariance between conditions, there's so many confounding factors it's probably difficult to tease out any sort of significant r^2 for an…

"Statistics assumes independence" What exactly do you mean by this?

I think they mean most statistics are simply "you have x% chance of y" when the chance of having y given the prior that you're in the ER may be different

Re: Bias in the ER

#24

Post by Baeocystin »

spqr0a1 wrote: post #19
chimeracoder wrote: post #14

Earlier quoted context omitted.

> Silver plating would sterilize some pathogens in as little as 5 minutes That would be very expensive for very little benefit - five minutes is more than long enough for multiple people to use the same buttons at a busy hospital during the day. It's much better to promote behaviors like washing hands before touching food or mucous membranes (like rubbing your eyes) and using alcohol-based hand sanitizers when that i…

The importance of handwashing can't be overstated, it is one of the keystones of sanitation and public health! Hospital transmitted infections would go way down if staff followed all checklists to a T. It's a matter of defense-in-depth. When the traffic is heavy enough to have less than 5 minutes between contacts, how many more people would be infected after a week? As for cost, it would be more expensive but less so…

I agree with your assessment. Considering the constant work hospitals put towards maintaining a clean environment, it seems only natural to use self-sterilizing surfaces whenever possible, just as part of the overall system.

Re: Bias in the ER

#25

Post by nojvek »

djsumdog wrote: post #17
Hasz wrote: post #11

They hadn’t bothered to consider statistically far more likely causes of an irregular heartbeat. In Redelmeier’s experience, doctors did not think statistically. Statistics assumes independence, something that may be hard to come by in the ER. Even when you start factoring in the covariance between conditions, there's so many confounding factors it's probably difficult to tease out any sort of significant r^2 for an…

I had a professor in undergrad who worked on order entry research. He talked about one of the problems facing Vanderbilt as far as scanning costs. CT scans and MRI are crazy expensive. Trauma patient comes in, doc orders a CT scan, it comes back and he says, "shit, this doesn't tell me what I need to. I knew I should have ordered an MRI instead." They used a decision tree learning algorithm and trained it using attri…

Just curious why are MRI and CT machines so expensive? They are the ultimate tool for debugging the human body. Shouldn't they be very affordable?

Re: Bias in the ER

#26

Post by mvp »

eraboli wrote: post #13
moxious wrote: post #4

There's a book called "Thinking Fast and Slow" by Daniel Kahneman that talks about systematic bias in human heuristic thinking. > The more easily people can call a scenario to mind, the more probable they find it. This is practically a restatement of the "availability bias" from that book. It came to mind immediately when I saw the article's title "How can Medical Professionals Avoid Making Assumptions That Lead to M…

One thing to note is that the social priming studies in “Thinking Fast and Slow” are not very replicable [1] 1. https://replicationindex.wordpress.com/2017/02/02/reconstruc...

Are only 'priming studies' in doubt? Or are most of the studies in social psychology in doubt today? The experiments and conclusions used to fascinate me, but once you lose trust it becomes hard to believe again.

I used to think all these experiments are conducted on people vastly different from me or the people I interact with, so those findings are not applicable to me. But now it seems that those are not applicable even to people who are a lot like the subjects of the experiments.

I'm probably having the bias where one under the influence of a single significant factor ignores all the rest :).

Re: Bias in the ER

#27

Post by alphaoverlord »

snowpanda wrote: post #20
projektir wrote: post #2

I wonder how much this is influenced by medical staff being overworked.

I think there's more factors than that. Air traffic controllers are very overworked and they don't often cause collisions[1]. I think this part of the article is what the big problem is: “Eighty percent of doctors don’t think probabilities apply to their patients,” I've recently gone through 4 years of medical treatment, and it's still ongoing. Only to find out this week that I have Lyme disease. Given that the chanc…

https://en.m.wikipedia.org/wiki/Chronic_Lyme_disease

Chronic Lyme is very controversial and likely not the true etiology

Re: Bias in the ER

#28

Post by nordify »

nojvek wrote: post #25
djsumdog wrote: post #17

Earlier quoted context omitted.

I had a professor in undergrad who worked on order entry research. He talked about one of the problems facing Vanderbilt as far as scanning costs. CT scans and MRI are crazy expensive. Trauma patient comes in, doc orders a CT scan, it comes back and he says, "shit, this doesn't tell me what I need to. I knew I should have ordered an MRI instead." They used a decision tree learning algorithm and trained it using attri…

Just curious why are MRI and CT machines so expensive? They are the ultimate tool for debugging the human body. Shouldn't they be very affordable?

Scans do not need to be crazy expensive.

In Finland, unsubsidized, undiscounted and no questions asked, just pay prices for scans from a private health company are 258€.

Expensive, yes. Crazy expensive, no.

Re: Bias in the ER

#29

Post by poikniok »

djsumdog wrote: post #17
Hasz wrote: post #11

They hadn’t bothered to consider statistically far more likely causes of an irregular heartbeat. In Redelmeier’s experience, doctors did not think statistically. Statistics assumes independence, something that may be hard to come by in the ER. Even when you start factoring in the covariance between conditions, there's so many confounding factors it's probably difficult to tease out any sort of significant r^2 for an…

I had a professor in undergrad who worked on order entry research. He talked about one of the problems facing Vanderbilt as far as scanning costs. CT scans and MRI are crazy expensive. Trauma patient comes in, doc orders a CT scan, it comes back and he says, "shit, this doesn't tell me what I need to. I knew I should have ordered an MRI instead." They used a decision tree learning algorithm and trained it using attri…

Bigger issue with CT scans is the radiation, they absolutely destroy the brain tissue.

Re: Bias in the ER

#30

Post by wallace_f »

I wasn't aware of this, from the article, which appears to me to be a very, very big deal

> more people died every year as a result of preventable accidents in hospitals than died in car crashes—which was saying something

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