The informed medical decision making

In this post, I’ll discuss some initiatives that began in the U.S. long before the emergence of the internet, but now, with the explosion of communication channels and social networks, these have taken on an impressive dimension that I’d like to bring to your knowledge and appreciation because, as we stand today in our environment, we are very far from these advances.

Healthwise is a U.S. company offering all kinds of solutions helping healthy people to better preserve their health and patients to better understand their disease. Many assurances, such as Kaiser Permanente, are offering Healthwise products and solutions to their members, with the aim of supporting policies of empowerment.

"The Surgical Signature" and how the patients can influence the overtreatment

In his latest book, Tracking Medicine, presented in the first post of this blog, Wennberg says that it’s possible to recognize a hospital by their rates of interventions profile (population-based) from a small handful of surgical procedures. And he demonstrates it with the following graph:

The analysis of the 5 selected areas in this 1975 work shows the profile of five surgical procedures ("The Surgical Signature") of each of them. So you can see that the men of Portland have the highest probability of the series to be undergoing prostatectomy (50% above the average), while citizens of the same Portland, in general, have the lower odds of having haemorrhoidectomy (40% below the average), Lewiston women face the highest rates of hysterectomy (60% above), in Augusta the average varicose extractions doubles, Waterville is the champion in operating haemorrhoids (nearly triples average) and finally the Bangor area is only notable for having the lowest rates of prostatectomy’s series.

The paper concludes that variations in the use of surgical resources are observed not only in comparisons between systems (see previous post) but also, the phenomenon has a land mark that does not correspond with the socio-demographic characteristics (which are adjusted) nor with the prevalence of diseases susceptible to surgical intervention.