Thursday, 16 January 2014

Liverpool Care Pathway - To Diagnose Or To Miss Diagnosis...?

Is the Emperor in the all together, the all together...?
"Yea," QOF he, "And dost thou fall upon thy face?"

The fallacy of statistical expectations...

How do you diagnose what is not there to diagnose, and is over-diagnosis ‘good’ diagnosis and under-diagnosis ‘poor’ diagnosis?

This is Dr. Martin Brunet in his own view in Pulse
As part of his on-going, military-styles engagement with the enemy that is dementia, and with great fanfare, Jeremy Hunt has launched a new Government website to name and shame regions of the country over their diagnosis rates for the condition. But I have a problem - and I would like our Health Secretary to help me here; to lend me a portion of his clinical judgement; aid me in the application of scientific scrutiny - because I am not sure if I should be ‘named’ or ‘shamed’. 
You see, for the government - with powerful vested interests in the big business that is dementia care whispering in their ear - more is always better and high diagnosis rates can only be a mark of good practice. Keen to do well, it was with the air of a schoolchild being handed back their test results that I checked the statistics for my practice - to find that we have a diagnosis rate of 126.7%! Can more always be better? Is it possible to have too much of a good thing? How can we have diagnosed more people than are out there?
The Emperor, in his deliberations, is as determined to hunt down the one percent.
The statistics have determined this to be so and cannot be wrong.
Applying interpolation of data to determine a target for diagnosis is not safe.
It ain't necessarily so
It ain't necessarily so
The things yo' projected
An’ what yo' expected
It ain't necessarily so
[Apologies to Gershwin]
Further reading -
Liverpool Care Pathway - The Palliative Option

Liverpool Care Pathway - So What's The News?

Liverpool Care Pathway - Ten Years In The Waiting

Liverpool Care Pathway - The Palliative Option And Downsizing Care

It was Dr. Barton's claim that she could look at someone and tell that they were dying.

The 'Surprise Question' recommends to GPs that they do just that in their hunt for their 1%.

This quote is in the Review. The errors of misdiagnosis are common knowledge. They are all quite, quite arrogant.

No comments:

Post a Comment