samedi 24 octobre 2015

London the Brit' eccentricity

London crazy swimming pool

vendredi 23 octobre 2015

Predictable human behavior by machines but unpredictable consequences?

Deep Feature Synthesis

It is not a new computer.It is the end of human superiority in research.
As we invented machines to execute difficult tasks for us because of time, space or energy, we are inventing machines which will carry on research, discovery faster and more efficiently than millions of human brains.

Is second opinion the fastest and the more efficient way to reduce unnecessary medical procedures and medical errors?

"Medical Error Reduction
Preventable medical errors - the 6th biggest killer in America!

Preventable medical errors kill and seriously injure hundreds of thousands of Americans every year. service is important in preventing medical errors. As a result we help lower health care costs, reduce doctors’ insurance premiums and protect the health and well-being of patients.

Many recent studies report that the majority of Americans are concerned about medical errors. According to the Journal of Cancer, it has been discovered that up to 30% of cancers are misdiagnosed or missed by doctors. Other research shows that more than 50% of breast cancer patients who received a second-opinion had a change in their recommended treatment plan. The Journal of Radiology published a study claiming that error rates can be as high as 30%, even in the vital diagnosis of cancer.

While it is not always the case, when they do occur, these errors, missed-findings, misinterpretations and improper recommendations lead to delayed medical treatment, or no treatment at all, which may lead to a horrible experience for the patient. Obtaining a medical second opinionhelps to eliminate the possibility for misinterpretation or missed findings.
Diagnosis Error Is Costliest and Most Common Medical Mistake

According to a recent study conducted by the National Practitioner Data Bank that examined 25 years of malpractice payments, diagnostic errors are the leading cause of death due to medical errors. It is also estimated that 40,000 -80,000 Americans die from incorrect diagnoses each year. The study found:
Among claims filed for medical malpractice, misdiagnosis was the most routine and the most dangerous medical mistake made in the U.S. over the past 25 years, a study found.
Death was the outcome more often in malpractice allegations related to diagnostic errors than in any other category of malpractice allegation.

Among 350,706 medical malpractice payments reported to a national database over a quarter-century, researchers found that 100,249 (28.6%) were the result of diagnosis errors, while 27.2% were from treatment errors and 24.2% were from surgery-related errors, wrote David E. Newman-Toker, MD, of Johns Hopkins Hospital, and colleagues. Diagnostic errors resulted in 40,000 to 80,000 deaths, they said, and cost $38 billion in malpractice claims payouts.
Dollars better spent on patient safety

The Center for Medicare & Medicaid Services (CMS) has, in recent years, recognized the potential for financial savings by reducing medical errors. CMS has stopped paying for hospital and practitioner errors, and thus created a financial incentive for hospitals to embrace patient safety.
Recent Patient Surveys

Almost a third of Americans reported experiencing (or a close friend or family member) a medical error, according to several recent consumer survey. Such errors include wrong diagnosis which results in wrong treatment or surgey. Completed in July 2012, this survey consisted of telephone interviews with U.S. consumers. Over 70% of them reported being very concerned or somewhat concerned about medical mistakes, and more than 20% reported having been misdiagnosed by a clinician.

Many Americans are taking additional steps to help minimize mistakes. 66% said they did their to have done their own research to validate a diagnosis or treatment plan. Over half (56%) sought a second opinion. Some other steps taken to prevent medical errors includeded delaying procedures until a day when a clinician might be more rested or focused, writing information down for the doctor or nurse, and, surprisingly, asking a clinician or nurse to wash their hands (18% of respondents admitted having to ask). Women are more likely than men to do research and get a second opinion.

This recent survey also showed that many patients have strong confidence in technology being able to help reduce medical errors. 68% of those surveyed agreed that technology has had a positive impact in reducing the chance for medical mistakes.
Recent Physician survey

In a recent survey of over 6,000 medical doctors, 50% of them said diagnostic errors occur in their office every month, and many of those errors cause direct harm to the patients.

Patients may be able to reduce diagnostic errors by seeking a second opinion. Many trust their physicians, but when a doctor fails to properly diagnose the patient in a timely manner, they could be guilty of medical malpractice. According to a study, radiologists at Johns Hopkins found that almost 8% of radiological scans they reviewed had significant discrepancies. After the final diagnosis was given, the second opinion was found to be correct 84% of the time."

Market and competition in healthcare, the case of Daraprim: faster, cheaper and more efficient than government tariffs

dimanche 18 octobre 2015

Surgical risk calculator

On line post op visits: less time and high accuracy

Bariatric surgery: the fall of a unnecessary technique?

"Patients undergoing bariatric surgery have an increased risk for self-harm emergencies after the surgery. These adverse events undermine the overall benefits of bariatric surgery. The study findings could be useful for bariatric surgeons and emergency physicians in postoperative follow-up. Additional clinical implications include active postoperative screening for self-harm risk among patients who have undergone bariatric surgery and are presenting for follow up. Patient and surgery factors could help identify vulnerable patients. Overall, these findings imply that more work is needed to understand why self-harm behaviors increase in the postoperative period and how these risks might be reduced."

Uberisation is an innovative answer to K Popper legitimate concern about freemarket

“The problem of the free market, mentioned in the text only in its application to the labour market, is of very considerable importance. Generalizing from what has been said in the text, it is clear that the idea of a free market is paradoxical. If the state does not interfere, then other semi-political organizations such as monopolies, trusts, unions, etc., may interfere, reducing the freedom of the market to a fiction. On the other hand, it is most important to realize that without a carefully protected free market, the whole economic system must cease to serve its only rational purpose, that is, to satisfy the demands of the consumer. If the consumer cannot choose; if he must take what the producer offers; if the producer, whether a private producer or the state or a marketing department, is master of the market, instead of the consumer; then the situation must arise that the consumer serves, ultimately, as a kind of money-supply and rubbish-remover for the producer, instead of the producer serving the needs and desires of the consumer.
Here we are clearly faced with an important problem of social engineering: the market must be controlled, but in such a way that the control does not impede the free choice of the consumer and that it does not remove the need for the producers to compete for the favour of the consumer. Economic 'planning' that does not plan for economic freedom in this sense will lead dangerously close to totalitarianism.
Karl Popper, 'The Open Society and Its Enemies' (note 26 to chapter 20).

Le terrorisme est bien l'instigateur des attentats en Europe


Marshall's plan is a myth