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The "NUTS" statistic: Applying an EBM disease model to defensive medicine.

dc.contributor.authorAllen, Robert
dc.contributor.authorCai, Angela G
dc.contributor.authorTepler, Peter
dc.contributor.authordeSouza, Ian S
dc.date.accessioned2023-01-30T17:49:33Z
dc.date.available2023-01-30T17:49:33Z
dc.date.issued2021-09-15
dc.identifier.citationAllen R, Cai AG, Tepler P, deSouza IS. The "NUTS" statistic: Applying an EBM disease model to defensive medicine. J Healthc Risk Manag. 2022 Jan;41(3):9-12. doi: 10.1002/jhrm.21486. Epub 2021 Sep 15. PMID: 34528329.en_US
dc.identifier.eissn2040-0861
dc.identifier.doi10.1002/jhrm.21486
dc.identifier.pmid34528329
dc.identifier.urihttp://hdl.handle.net/20.500.12648/8179
dc.description.abstractPhysicians 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.
dc.language.isoenen_US
dc.relation.urlhttps://onlinelibrary.wiley.com/doi/epdf/10.1002/jhrm.21486en_US
dc.rights© 2021 American Society for Healthcare Risk Management of the American Hospital Association.
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International*
dc.rights.urihttp://creativecommons.org/licenses/by-nc-nd/4.0/*
dc.titleThe "NUTS" statistic: Applying an EBM disease model to defensive medicine.en_US
dc.typeArticle/Reviewen_US
dc.source.journaltitleJournal of healthcare risk management : the journal of the American Society for Healthcare Risk Managementen_US
dc.source.volume41
dc.source.issue3
dc.source.beginpage9
dc.source.endpage12
dc.source.countryUnited States
dc.description.versionAMen_US
refterms.dateFOA2023-01-30T17:49:33Z
html.description.abstractPhysicians 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.
dc.description.institutionSUNY Downstateen_US
dc.description.departmentEmergency Medicineen_US
dc.description.degreelevelN/Aen_US
dc.identifier.journalJournal of healthcare risk management : the journal of the American Society for Healthcare Risk Management


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© 2021 American Society for Healthcare Risk Management of the American Hospital Association.
Except where otherwise noted, this item's license is described as © 2021 American Society for Healthcare Risk Management of the American Hospital Association.