Measuring the effectiveness and value of clinical practice

In the "XIV Conference of the Sign Foundation", Jens Deerberg-Wittram, Director of the Boston Consulting Group, gave the inaugural lecture entitled "From volume to value". It was a very timely speech, at a time when the obsessive control of budgets and waiting lists prevents clinicians and managers from reflecting on what contributes so much care activity to society. The concept of value expressed by the German speaker is very new for healthcare managers, who tend to understand clinical effectiveness as a rhetorical concept more typical of epidemiological studies.

Let's finish with the phrase "This has always been done like this"

Mònica Almiñana



There are more and more voices defending that our current model of health care ought to improve and that, if we don’t change it, it will change us.

But, to achieve this change, we need foundations from which to build upon. In my opinion, undoubtedly, there are three essential levers for this transformation: data intelligence (big data), patient safety and patient experience. The three are increasingly interrelated, and if not, read the report presented this year by the ECRI Institute: "Top 10 Patient Safety Concerns for 2018".

It’s estimated that the waste in biomedical research reaches 85%

In 2014, following concerns over the poor quality of biomedical research, The Lancet published a series of 5 articles analysing the scope of the problem and proposing solutions and as a result of this Reward Alliance was born, a platform that aims to defend the value of the research, from which I have extracted the scandalous figure of 85% and, according to Paul Glasziou and Iain Chalmers, two of the leaders of the movement, the volume of money squandered by biomedical research could reach 170 billion dollars annually, an amount higher than Hungary's gross domestic product. The two authors, who already predicted this figure in 2009, argue that this amount comes from an accumulation of up to three times 50%.

The individualistic short-sightedness of health care

The Global Action Plan for the prevention and control of non-communicable diseases of the WHO aims to reduce by 25% the premature mortality due to these pathologies by the year 2025 (strategy 25 x 25) and, therefore, concentrates on strategies that reduce the following 7 risk factors: a) alcohol consumption, b) insufficient physical activity, c) tobacco consumption, d) high blood pressure, e) excessive salt intake, f) diabetes, and g) obesity. Confronted by this individualistic drift of public health, an international group of researchers has published in the Lancet the results of a meta-analysis with 48 cohort studies and 1.7 million individual records, where they have shown that poverty has more explanatory force by itself over the number of years of life lost that many of the factors 25 x 25, in addition to having an undeniable cross-influence by enhancing the aforementioned risk factors. It’s important to clarify that the cohorts selected by the researchers correspond to first world countries, so the analyzed groups of low socio-economic level  represent poverty pockets that are basically concentrated in deprived neighbourhoods of large cities or in certain collectives such as the destitute or the immigrants.

On average, humans have one testicle

Joan Escarrabill

This article deals with the interpretation of data. The title is an example made by Daniel Levitin in his suggestive book Weaponized Lies: How to Think Critically in the Post-Truth Era (Penguin Random House, New York, 2017), about the mistakes that can be made and the lies that can be said according to how numerical data is exposed. Obviously, the title of the article is exact. If the proportion of men and women is about 50%, certainly humans, on average, we have a testicle (and an ovary).