Robert Allen MD, Angela G. Cai MD, MBA, Peter Tepler MD, Ian S. deSouza MD
{"title":"The “NUTS” statistic: Applying an EBM disease model to defensive medicine","authors":"Robert Allen MD, Angela G. Cai MD, MBA, Peter Tepler MD, Ian S. deSouza MD","doi":"10.1002/jhrm.21486","DOIUrl":null,"url":null,"abstract":"<p>Physicians believe that malpractice concerns result in unnecessary testing, and many emergency physicians state that avoiding malpractice is a contributing factor to ordering medically unnecessary tests. Unfortunately, defensive medicine does not come without possible harm to patients who may be subject to non-beneficial, downstream testing, procedures, and hospitalizations. We submit a novel statistic, “NUTS” or “Number of Unnecessary Tests to avoid one Suit. ” We calculated a NUTS of 4737 for troponin testing in ED patients with suspected myocardial infarction, meaning a clinician will need to order 4737 medically unnecessary troponin tests to avoid one missed myocardial infarction lawsuit. The NUTS framework offers us an evidence-based lens to examine defensive medicine less superstitiously and more based on currently available data.</p>","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"41 3","pages":"9-12"},"PeriodicalIF":0.0000,"publicationDate":"2021-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1002/jhrm.21486","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","FirstCategoryId":"1085","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jhrm.21486","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 2
Abstract
Physicians believe that malpractice concerns result in unnecessary testing, and many emergency physicians state that avoiding malpractice is a contributing factor to ordering medically unnecessary tests. Unfortunately, defensive medicine does not come without possible harm to patients who may be subject to non-beneficial, downstream testing, procedures, and hospitalizations. We submit a novel statistic, “NUTS” or “Number of Unnecessary Tests to avoid one Suit. ” We calculated a NUTS of 4737 for troponin testing in ED patients with suspected myocardial infarction, meaning a clinician will need to order 4737 medically unnecessary troponin tests to avoid one missed myocardial infarction lawsuit. The NUTS framework offers us an evidence-based lens to examine defensive medicine less superstitiously and more based on currently available data.
期刊介绍：
The Journal of Healthcare Risk Management is published quarterly by the American Society for Healthcare Risk Management (ASHRM). The purpose of the journal is to publish research, trends, and new developments in the field of healthcare risk management with the ultimate goal of advancing safe and trusted patient-centered healthcare delivery and promoting proactive and innovative management of organization-wide risk. The journal focuses on insightful, peer-reviewed content that relates to patient safety, emergency preparedness, insurance, legal, leadership, and other timely healthcare risk management issues.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
