6 ms·

Computer glitch has led to incorrect advice on statins

32 points by gulda 10y ago

austinjp 10y ago
"About one in three UK family doctors’ practices use a computer program made by the IT company TPP" instead of online calculators such as www.qrisk.org "Last month the firm told the UK government that there is a problem with the software, and it has been overstating the risk for some people, while understating it for others. The government informed GPs of this on Wednesday." Statins are controversially prescribed to people deemed at risk of illnesses such as stroke and heart disease e.g. if they exhibit risk factors such as smoking, or family history of these diseases. "The software has been used since 2009." There's some political "flavour" in the last half of the article about time-pressures faced by GPs, targets, guidelines, and the fact that risk-factors should not be used as the sole justification for prescribing statins. Can't find anything on "TPP". Non-paywalled versions of the story: http://www.telegraph.co.uk/news/2016/05/11/statins-glitch-means-thousands-may-have-been-incorrectly-prescri/ http://www.telegraph.co.uk/news/2016/05/11/statins-glitch-me... http://www.bbc.co.uk/news/health-36274791 http://www.bbc.co.uk/news/health-36274791
- jgrahamc 10y ago
  http://www.tpp-uk.com/ http://www.tpp-uk.com/ They apparently make the god-awful "SystmOne" system that my local GP uses for appointments.
  - rossng 10y ago
    There are some pretty crazy stories online about what TPP is like internally. https://www.glassdoor.co.uk/Reviews/Employee-Review-The-Phoenix-Partnership-RVW7980679.htm https://www.glassdoor.co.uk/Reviews/Employee-Review-The-Phoe... I guess it shouldn't come as much of a surprise that a large healthcare software company is horrifyingly dysfunctional.
- homero 10y ago
  Should I get off statins?
  - rhinoceraptor 10y ago
    You can get a coronary calcium scan to see if you actually have arterial plaques.
voidz 10y ago
"glitch" is such an awful, handwavey word. Please, describe the cause in a more intelligible way than by using this stupid word.
- a3n 10y ago
  From the Reagan administration: "Mistakes were made."
- d_theorist 10y ago
  No Agenda?
  - deleted 10y ago
    [deleted]
- kalleboo 10y ago
  Seriously... It seems like a convenient way for journalists to avoid having to explain how technology works. At the same time I keep technology looking like magic and not science. "Glitch" makes it sound like bugs are caused by cosmic rays or something.
- petra 10y ago
  The program by TPP connects to a medical risk calculator called QRISK2. Apparently they(TPP) have some error in this interface.
aaron695 10y ago
Big point. It seems the doctors (As in none????) didn't notice it was making mistakes. All of them, not noticing since 2009. The glitchy program still was better than the doctors knowledge base. I'd pick the program anyday. Imagine the failure rate of the 2/3 who don't use the program.
- e40 10y ago
  How about not relying on a Dr. or a program and taking your health care into your own hands? Research and review and ask questions and don't just take w/o questioning the advice either give? Statins have serious side effects. I would never take them without doing my own research. EDIT: I don't mean "research" in the scientific sense, but in the "look into it" sense.
  - JamesBarney 10y ago
    This method needs to be compared in effectiveness against the above 2 approaches. Assume I'm a run of the mill dude without a biomedical background. I decide to read up on the current literature relating to statins. After going through these highly technical studies I find a conflict between what the doctor/program is telling me and what I thought I read. Now what are the odds I'm right and the doctor/program are wrong?
    - lawnchair_larry 10y ago
      High
    - e40 10y ago
      You have the great advantage of all of the information. That clear advantage will greatly benefit you. EDIT: by "all the information" I mean the sum total of all your health information. Even if you are at an HMO (e.g., Kaiser), not everything is written in your record and not every Dr. will read your entire record. Also, only you can order a 2nd opinion, based on the facts you know. A Dr. will never order a 2nd opinion. I have literally never heard of this, but if it does happen, it is exceedingly rare.
dzdt 10y ago
Hopefully someone will run the numbers from this. Effectively it is a large scale test of outcomes for patients with equal risk factors, some treated with statins and some untreated.
- ylem 10y ago
  I had the exact same thought--it's unfortunate that this happened, but some good might come of it as a randomized control trial...
DanBC 10y ago
This bug is worrying. EU Spreadsheet Risk Interest Group (EUSPRIG) released a report in 2006 about spreadsheet errors in medicine, which some people might be interested in. http://www.eusprig.org/2006/spreadsheets-in-clinical-medicine-warning.pdf http://www.eusprig.org/2006/spreadsheets-in-clinical-medicin...

32 points by gulda 10y ago

"About one in three UK family doctors’ practices use a computer program made by the IT company TPP" instead of online calculators such as www.qrisk.org "Last month the firm told the UK government that there is a problem with the software, and it has been overstating the risk for some people, while understating it for others. The government informed GPs of this on Wednesday." Statins are controversially prescribed to people deemed at risk of illnesses such as stroke and heart disease e.g. if they exhibit risk factors such as smoking, or family history of these diseases. "The software has been used since 2009." There's some political "flavour" in the last half of the article about time-pressures faced by GPs, targets, guidelines, and the fact that risk-factors should not be used as the sole justification for prescribing statins. Can't find anything on "TPP". Non-paywalled versions of the story: http://www.telegraph.co.uk/news/2016/05/11/statins-glitch-means-thousands-may-have-been-incorrectly-prescri/ http://www.telegraph.co.uk/news/2016/05/11/statins-glitch-me... http://www.bbc.co.uk/news/health-36274791 http://www.bbc.co.uk/news/health-36274791

jgrahamc 10y ago
http://www.tpp-uk.com/ http://www.tpp-uk.com/ They apparently make the god-awful "SystmOne" system that my local GP uses for appointments.
- rossng 10y ago
  There are some pretty crazy stories online about what TPP is like internally. https://www.glassdoor.co.uk/Reviews/Employee-Review-The-Phoenix-Partnership-RVW7980679.htm https://www.glassdoor.co.uk/Reviews/Employee-Review-The-Phoe... I guess it shouldn't come as much of a surprise that a large healthcare software company is horrifyingly dysfunctional.
homero 10y ago
Should I get off statins?
- rhinoceraptor 10y ago
  You can get a coronary calcium scan to see if you actually have arterial plaques.

voidz 10y ago

"glitch" is such an awful, handwavey word. Please, describe the cause in a more intelligible way than by using this stupid word.

a3n 10y ago
From the Reagan administration: "Mistakes were made."
d_theorist 10y ago
No Agenda?
- deleted 10y ago
  [deleted]
kalleboo 10y ago
Seriously... It seems like a convenient way for journalists to avoid having to explain how technology works. At the same time I keep technology looking like magic and not science. "Glitch" makes it sound like bugs are caused by cosmic rays or something.
petra 10y ago
The program by TPP connects to a medical risk calculator called QRISK2. Apparently they(TPP) have some error in this interface.

aaron695 10y ago

Big point. It seems the doctors (As in none????) didn't notice it was making mistakes. All of them, not noticing since 2009. The glitchy program still was better than the doctors knowledge base. I'd pick the program anyday. Imagine the failure rate of the 2/3 who don't use the program.

e40 10y ago
How about not relying on a Dr. or a program and taking your health care into your own hands? Research and review and ask questions and don't just take w/o questioning the advice either give? Statins have serious side effects. I would never take them without doing my own research. EDIT: I don't mean "research" in the scientific sense, but in the "look into it" sense.
- JamesBarney 10y ago
  This method needs to be compared in effectiveness against the above 2 approaches. Assume I'm a run of the mill dude without a biomedical background. I decide to read up on the current literature relating to statins. After going through these highly technical studies I find a conflict between what the doctor/program is telling me and what I thought I read. Now what are the odds I'm right and the doctor/program are wrong?
  - lawnchair_larry 10y ago
    High
  - e40 10y ago
    You have the great advantage of all of the information. That clear advantage will greatly benefit you. EDIT: by "all the information" I mean the sum total of all your health information. Even if you are at an HMO (e.g., Kaiser), not everything is written in your record and not every Dr. will read your entire record. Also, only you can order a 2nd opinion, based on the facts you know. A Dr. will never order a 2nd opinion. I have literally never heard of this, but if it does happen, it is exceedingly rare.

dzdt 10y ago

Hopefully someone will run the numbers from this. Effectively it is a large scale test of outcomes for patients with equal risk factors, some treated with statins and some untreated.

ylem 10y ago
I had the exact same thought--it's unfortunate that this happened, but some good might come of it as a randomized control trial...

DanBC 10y ago

This bug is worrying. EU Spreadsheet Risk Interest Group (EUSPRIG) released a report in 2006 about spreadsheet errors in medicine, which some people might be interested in. http://www.eusprig.org/2006/spreadsheets-in-clinical-medicine-warning.pdf http://www.eusprig.org/2006/spreadsheets-in-clinical-medicin...