Inter-unit comparisons are flawed

Drug compendia in oncology: are they flawed?

R ecent studies have raised concerns about the reliability of four compendia currently used by Medicare and other payers to help determine which cancer drugs will be covered for which offlabel indications. Now, experts are looking for ways to improve the compendia, even as oncologists debate their usefulness to guide treatment decisions. The studies, a series of reports funded by the Centers fo...

Arguments against helmet legislation are flawed.

Are the current perioperative risk management strategies for myocardial infarction flawed? Coronary Assessment Before Noncardiac Surgery Current Strategies Are Flawed

The preoperative evaluation of patients scheduled for elective noncardiac surgery is a conspicuous component of the practice of cardiology and general internal medicine and has become a standard content area in general internal medicine training.1 In particular, clinicians are expected to address coronary risk in such patients because the stress of surgery, induction of anesthesia, postoperativ...

Establishing inter-hospital comparisons of outcomes.

This paper describes the ongoing development of a region-wide system for monitoring the short-term outcomes of total knee replacement surgery. The system aims to collect data from a dozen hospitals, and relies on a close collaboration with locally based surgeons and medical audit staff. The intention is to provide routine comparative information based on a broad conception of outcome, that incl...

Mean dynamic topography: inter-comparisons and errors.

Knowledge of the ocean dynamic topography, defined as the height of the sea surface above its rest-state (the geoid), would allow oceanographers to study the absolute circulation of the ocean and determine the associated geostrophic surface currents that help to regulate the Earth's climate. Here a novel approach to computing a mean dynamic topography (MDT), together with an error field, is pre...