full free access: Associations Between Physician Characteristics and Quality of Care - The Commonwealth Fund

Synopsis

A Massachusetts study found many of the criteria available to patients when selecting a physician—including years of experience, paid malpractice claims, and medical school rankings—are not associated with higher quality care.

Key Findings

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• Three of the characteristics studied were associated with marginal differences in performance quality: female physicians scored 1.6 percentage points higher than male physicians; board-certified physicians scored 3.3 points higher than physicians without board certification; and U.S.-trained physicians scored 1 point higher than physicians trained abroad.
• There were no statistically significant associations between performance and malpractice claims, disciplinary actions, years of practice, medical school ranking, or type of medical degree (i.e., allopathic vs. osteopathic).
• The difference in overall performance between the average physician with the best combination of characteristics (female, board-certified, domestically trained) and the average physician with the worst combination (male, noncertified, internationally trained) is only 5.9 percent.
• Among the middle 90 percent of physicians studied who had the best combination of characteristics, there was a wide range of performance scores—from 49 percent to 75 percent—very similar to the range for all physicians. This suggests that patients are unlikely to receive higher-quality care by switching to a physician who has these characteristics.

Respecting And Reflecting On Diagnostic Errors – Health Affairs Blog

".....The neglected importance of empowering patients. Even more important than supporting clinicians in diagnosis-related functions is recognizing and supporting patients in their role as co-producers of diagnosis. This largely unexplored aspect of diagnosis improvement represents another essential pillar in making diagnoses more timely, accurate, reliable, and efficient. Patients can make valuable contributions by seeking timely access for worrisome symptoms; providing accurate and thorough histories; sharing their hunches about possible exposures or etiologies; helping ensure that test results are reported back; following up with feedback about expected improvement; adhering to empirical treatment trials permitting accurate re-assessment of preliminary diagnoses; respecting limits on staff time and societal resources; and in some cases even getting involved with disease-specific or generic patient safety advocacy organizations.
In contemplating such patient contributions to timely and accurate diagnosis, it is important that we not shift our responsibilities onto sick patient. Instead we need to imagine and facilitate an enhanced role for patients to play. The key question is: what will it take at the provider and institutional level to empower patients to take on these roles and help them flourish in them?
The journey continues: the upcoming third annual conference on diagnostic errors. Let’s hope we don’t have to wait for the “high-profile errors” Wachter cites to kill more patients for diagnostic errors to get their due respect. Enough “low-profile” diagnostic delays, needless morbidity, inefficiencies, missed diagnoses, and even deaths are already happening every day. Hopefully the next highly profiled event will instead be the upcoming 3^rd Annual AHRQ-sponsored International Conference on Diagnosis Errors in Medicine next month in Toronto. Here we will again bring together engaged clinicians, researchers, academics, quality improvement and risk management professionals and patients—all dedicated to a common goal—to better understand and reduce medical errors and to reduce the harm from missed and delayed diagnoses....."

Aetna Funds BRCA Gene Test Study (Florida) GenomeWeb

BMJ - Personal View: Researchers raise concerns over the increasing commercialization of science

"...Extreme commercialisation of science can also lead to patents on medical procedures and techniques, say the authors. However, the American Medical Association recently concluded that it is unethical for physicians to seek, secure or enforce patents on medical procedures...."

Open Label Study to Assess Efficacy and Safety of Olaparib in Confirmed Genetic BRCA1 or BRCA2 Mutation Pats - Full Text View - ClinicalTrials.gov

Neurological side-effects caused by recently approved chemotherapy drugs - e-Grand Round - Cancer World (full access)

Quality of pathology reports for advanced ovarian cancer: Are we missing essential information?: (multinational study)

Note: a related is the international shortage of oncologic pathologists

Quality of pathology reports for advanced ovarian cancer: Are we missing essential information?: An audit of 479 pathology reports from the EORTC-GCG 55971/NCIC-CTG OV13 neoadjuvant trial  

Conclusion This audit of ovarian cancer pathology reports reveals that in a substantial number of reports basic pathologic data are missing, with possible adverse consequences for the quality of cancer care. Specialisation by pathologists and the use of standardised synoptic reports can lead to improved quality of reporting. Further research is needed to better define pre- and post-operative diagnostic criteria for ovarian cancer treated with neoadjuvant chemotherapy.

Expert Opinion on Drug Metabolism & Toxicology - Effects of herbal products on the metabolism and transport of anticancer agents (multinational study)

Note: short abstract

Controversies in Gynecology Oncology - Dr Kate O'Hanlan - video (repeat posti)

Dr. Kate O’Hanlan is a Gynecologic Oncologist practicing in the San Francisco Bay Area, formerly on the faculty at Stanford University and Albert Einstein College of Medicine. Join her as she discusses some of the latest developments in gynecological cancer and sorts fact from fiction. Series: Women’s Health Today [5/2007]

Why are we copyrighting science? -- de Silva and Hanwella 341 -- bmj.com

"...Scales are also used to assess patients’ levels of functioning, quality of life, satisfaction with services, and burden on carers. Of the many hundred scales developed for use in medicine only a few gain wide acceptance among researchers. Scales used in many specialties, such as the general health questionnaire and the mini-mental state examination, have been copyrighted. Some copyrighted scales are first published in journals and are available free to researchers. However, once a rating scale is accepted by the scientific community an updated version is copyrighted,..."