Edward J. Schloss, MD reviews the recent controversy over ProPublica's recent sensationalized public reporting of administratively-collected surgical mortality and readmission data:
"Some have argued that it was important to get this data out for public review, despite it’s limitations. I respectfully disagree. I subscribe to the belief that bad data is worse than no data. Certainly the scientific literature is replete with examples that prove this correct.His analysis is a "must-read" for it speaks to many of the major flaws of using poorly collected and analyzed Big Data to improve medical care.
So is Surgeon Scorecard bad data? Strong words, but I say yes. This analysis was a great idea, but it fails to deliver on its goals. The data and methodology both have significant flaws. I say that from the perspective of a working clinician and clinical researcher with over 20 years experience, but I’d like to see a higher level of review. This project is as much science as it is journalism. Surgeon Scorecard should be peer reviewed and critically discussed as would any scientific outcomes study. As I suggested to ProPublica, we need to kick the tires."
This post reinforces an opinion I've held for quite a few years now. The world is an inherently easier place to deal with if your entire world view is an Excel spreadsheet. Unfortunately, real life is not quite that straightforward to deal with as many issues involving patient care and management appear quite different up close as compared to how things look on paper. I'd like to see more efforts to objectively evaluate the performance and tangible value added by the army of administrators that now seem to be tasked to evaluate every move made by physicians today.
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