Post date: Oct 21, 2010 7:45:30 AM
The Atlantic published a provoking article titled Lies, Damned Lies, and Medical Science which chronicles the work of a meta-researcher--Dr. John Ioannidis. His claim - "as much as 90 percent of the published medical information that doctors rely on is flawed". The article recounts how even the gold standard of medical research, randomized controlled trials, have found to be flawed. Ioannidis suggests "the studies were biased". He says “There is an intellectual conflict of interest that pressures researchers to find whatever it is that is most likely to get them funded.” and published.
What does this mean for HCIT research? Dr Ioannidis focuses his meta-analysis on focused clinical outcomes. HCIT research has to take the big picture asking the questions about context and applicability of a finding within a healthcare information system - not just one feature or function of a system. For example, e-prescribing significantly reduces errors from illegibility as one would expect since the inputs are typed. However, the studies I've seen don't look for errors of misspelling or incorrectly input - e-iatrogenesis errors. The studies also don't have a system view such as showing that prescribers using a formulary feature of e-prescribing have higher rates of prescribing generics. But for the medication management system, this limited view doesn't address how many prescriptions are filled with generics. After all, the majority of states in the United States allow pharmacists to make generic substitutions without approval of the prescriber.
Just as Dr. Ioannidis has been in the vanguard of meta-analysis research in medicine, I want to promote synthesis research - in all its forms - to the HCIT research community. This website is just a drop in the bucket of what could be done but I hope some of the inter-disciplinary aggregation of resources found here will be useful to others.