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What's wrong with the simple solution, i.e., understanding when the algorithms apply and when they don't? For example, if an RCT shows that in-hospital initiati
by firejake308 2y ago
What's wrong with the simple solution, i.e., understanding when the algorithms apply and when they don't? For example, if an RCT shows that in-hospital initiation of all 4 of the heart failure GDMT's leads to reduced mortality compared to delayed initiation of GDMT, then you also have to learn that 97% of patients in the study had a baseline SBP of at least 97. Therefore, maybe you shouldn't start 4 BP-lowering meds on your HF patient with a baseline SBP of 86. If people learn when to apply rules, then I think you don't need humanities education and you don't need a system-wide reset either.
- acheron 2y agoThe issue isn’t the doctor knowing when to use the algorithm and when to deviate, but explaining that deviating from the algorithm was the right choice to the judge and jury in the subsequent lawsuit.