| Index | Last Week | Contact DQ News | Latest Issue |
| Featured Articles | Data & Information | Science & Technology | Education |
| Economics | Business | Law | Medicine |
Industrial Quality Methodology - Lessons for Physicians
A February 1st article in The New Yorker examined the reasons physicians make grave mistakes when treating patients. The article, written by surgical resident and medical writer Atul Gawande, M.D., addressed the large number of serious errors made by physicians and other health care professionals by advocating improved processes and systems that significantly reduce error.
The article includes descriptions of two surgical procedures, one in an emergency room where the author made life-threatening mistakes and another during a "routine" gall bladder removal where the author almost made a life-threatening mistake. The author then questioned why he and other physicians continue to make such mistakes. The author refers to a review of medical practice published in The New England Journal of Medicine in 1991 - the Harvard Medical Practice Study. The study found that of more than 30,000 hospital admissons in New York State, nearly 4% of hospital patients suffered complications from treatment. One in four patients who suffered complications, or 1% of admissions, involved actual negligence. According to the author, almost everyone who cares for hospital patients will make serious mistakes, and even commit acts of negligence, every year.
Dr. Gawande then examines manufacturing systems, civil aviation, and even service-sector activities like hotels, where systems that generate problems at a 4% rate and serious problems at a 1% rate are totally unacceptable. He focuses on a medical specialty - anesthesiology - where the death rate resulting from anesthesia has been reduced from one death per 5,000 operations in the 1980's to one in 200,000 operations today. This was largely accomplished by redesigning and standardizing anesthesia machines, introducing monitors that can detect problems early, increasing training, reducing the causes of fatigue, eliminating the causes of errors whenever possible, and developing patient-anesthesia simulation systems similar to those used to simulate aircraft emergencies for airline pilots.
Unfortunately, Dr. Gawande doesn't view pro-active quality methodology as being able to make a drastic reduction in surgical mistakes anytime soon. The article begins on page 40.
'Cancer Clusters'....a Data Quality Issue?
This week, articles in The New Yorker and The New York Times explored the confusion generated by so-called "cancer clusters." Cancer clusters (or disease clusters) can be described as the number and geographic location of persons who live in a community affllicted by cancer or another disease is such that the disease may be attributed to the effects of endogenous (e.g., genetics) and exognenous (e.g., pollution) variables.
The major problems with "cancer clustering" is that people have been found to naturally clump cases of similar cancers, then seek a common cause for the disease. Second, problems in determining cancer etiology are inherent in disease clusters. If there are traces of pollutants in drinking water in Community A (with a cancer cluster) why are there no cancer clusters in Community B, with the same drinking water pollutants? Finally, some biostatisticians and epidemiologists believe that massive data collection and analyses could pinpoint the etiology of disease clusters. For even a small community this could require millions of samples of air, water, food, liquids, body fluids, as well as data about stress, diet, family history, family genetics, and extensive diaries of day to day activities. All compiled over several decades. Obviously, data and information quality would be paramount if such a study or studies were ever undertaken. Only a few democracies (notably Japan) have communities whose residents would willingly supply massive amounts of high quality personal data for decades.
For now, biostatisticians and epidemologists accept that disease clusters are hard to prove, in the absence of the outbreak of some rare disease. Articles by Gina Kolata and Polly Morrice appeared in the Times on January 31st and February 5th. An article by Atul Gawande, M.D., appeared in the February 8th issue of The New Yorker.
New U.S. Patents - Data Problems for Marketers?
Several patents were recently issued to a corporation that wants to change the way advertisting has traditionally been done - on the Internet and in other media. The corporation, Cybergold, Inc., of Berkeley, California, is seeking to have consumers compensated for reading on-line advertisements. The company also seeks to finds ways of allowing consumers to store direct marketing information about themselves - like their income bracket, zip code, profession, and hobbies - so they can be compensated every time they decide to release such information to advertisers.
The patents also cover a way of turning conventional advertising-based publishing on it's head. Consumers would be paid a tiny amount to read ads for works created by on-line authors. This money could then be used to pay for downloading copyrighted material stored on-line.
Several advocates who favor a open Internet are concerned about the implications of so-called "business methods" patents. At least one critic is planning to challenge the patents' validity on the grounds that the business methods aren't novel enough to be patented. Critics also complain that Cybergold's patents would allow politicians to "buy" votes by paying voters to read campaign advertisements Cybergod was recently awarded U.S. Patent 5,855,008. The patents' descriptions appeared on page C2 in the February 1st issue of The New York Times.
Briefly Noted
Medical Journals Rarely Disclose Researchers' Ties
According to a Wall Street Journal article on February 2nd, scientists are increasingly supported by for-profit companies, but a new study shows that critical fact is seldom revealed in published research. The article was written by Ralph King and appears on page B1.
High-Tech Firms Upset Over SEC Crackdown
The U.S. Securities and Exchange Commission is cracking down on popular corporate write-offs for "in-process research and development." The SEC believes that R & D accounting standards are being improperly used. R & D corporations say the SEC us being unfair. Michael Schroeder wrote The Wall Street Journal article, which appeared on February 1st on page B4. A related editorial in The Wall Street Journal on February 5th (page A14) praised the SEC for being neither recalcitrant nor overly-aggressive when the regulatory agency sanctions bad accounting.
Whose Information is It?
A report in the January 31st issue of The Washington Post discussed The Financial Information Privacy Act of 1999, legislation recently introduced in the U.S. Congress by several Democrats. The legislation would make it harder for institutions to disclose or sell financial information about their customers without their consent. The article's author, Michelle Singletary, discussed why financial organizations should be able to obtain data about individuals. The article appeared in the Business Section on page M2.
Economists Rush to Revise Forecasts
According to a report in the February 4th issue of The Wall Street Journal, Wall Street economists are rushing to revise previous predictions of slowing economic growth. Just a few weeks ago, economists expected growth to slow sharply during the first quarter and first half of 1999 as economic upheaval pinched U.S. corporate profits. But recently-released government statistics point to stronger, not weaker, growth in the months ahead. The report was written by Tristan mabry, and appears on page A2.
Morningstar Scales Back on Annuity Data
According to the February 1st issue of The Wall Street Journal, Morningstar, Inc. is scaling back on the information it offers to individual variable annuity buyers about variable annuities (tax deferred retirements with investment choices similar to mutual funds, usually offered by insurance companies. Morningstar feels that the way the variable-annuity market is structured, there is little need for competitive information by individual consumers. Morningstar feels that consumers will continue to buy annuities through brokers and agents, as opposed to looking for best buys and completing a transaction directly. The report appears in page C20.
Go to: Data Quality Home Page
Comments: dqemail@aol.com (1999-01-31)