This is amazing:
http://www.publicintegrity.org/2013/...ndustry-defeat
There's a law granting a standard, non-punitive-damages-like payout from mining companies to miners diagnosed with Black Lung. So the mining companies sent all the miners' x-rays to this radiologist at Johns Hopkins who appears to have invented his own diagnostic criteria, and stuck to it despite (a) disagreeing with every other doctor in the business and (b) being proven wrong hundreds of times by biopsies. The Center for Public Integrity and ABC did what sounds like a vast amount of legwork to put together case statistics that reveal his patterns of behavior. Terrible.
It's not just the herbal-therapy promoters who need to be held to the standards of evidence-based medicine. It's also the MDs.
Frighteningly, it sounds like this guy has learned to give the expected answers on his four-year radiology recertification tests, but goes back to his whackjob views when diagnosing actual patients. The CPI showed him the *standard x-rays*, the black lung type specimen, that he diagnosed successfully on these tests, but told him it was from a miner; he diagnosed it as not black lung.
It sounds like:
a) This doctor has a non-medical belief that black lung somehow "ought to" be very rare, so he diagnoses it rarely.
b) He seems to think of a Type I error (giving a black lung award to a miner without black lung) is a horrible injustice, and he seems utterly unbothered about Type II errors (failing to diagnose a real black lung case). So he's constructed his fake diagnostic criteria to deliver pure Type II errors all the time, guaranteeing his freedom from the sin of a Type I.
c) He's generally a pompous moron and scumbag.
http://www.publicintegrity.org/2013/...ndustry-defeat
There's a law granting a standard, non-punitive-damages-like payout from mining companies to miners diagnosed with Black Lung. So the mining companies sent all the miners' x-rays to this radiologist at Johns Hopkins who appears to have invented his own diagnostic criteria, and stuck to it despite (a) disagreeing with every other doctor in the business and (b) being proven wrong hundreds of times by biopsies. The Center for Public Integrity and ABC did what sounds like a vast amount of legwork to put together case statistics that reveal his patterns of behavior. Terrible.
It's not just the herbal-therapy promoters who need to be held to the standards of evidence-based medicine. It's also the MDs.
Quote:
Time and again, judges have deemed him the “best qualified radiologist,” and they have reached conclusions such as, “I defer to Dr. Wheeler’s interpretation because of his superior credentials.” ... “I think if they have [black lung], it should be up to them to prove it,” Wheeler said. To him, this means undergoing a biopsy. If miners don’t submit to the procedure, he said, it suggests they may be afraid the results will show they have something other than black lung. Biopsies are rarely necessary to diagnose the disease and can put the patient at risk, according to the American Lung Association, the National Institute for Occupational Safety and Health (NIOSH), the Labor Department, a paper published by the American Thoracic Society and prominent doctors interviewed by the Center. Told his higher standard of proof, which he maintains is ordinary medical practice, is not required by law, Wheeler held firm. “I don’t care about the law,” he said. ... In a case decided in 2010, a doctor disputed Wheeler’s narrow view of black lung, and the miner’s lawyer asked Wheeler during a deposition whether he could cite medical literature to support his views. “I don’t think I need medical literature,” Wheeler replied. ... He said he’s never been told an interpretation of his was wrong and he’d admit a mistake only if a biopsy or autopsy showed black lung — and was performed by a pathologist with “proper credentials.” “I know my credentials,” he said. “I'd like to make sure that the people proving me wrong … have … credentials as good as mine.” In fact, tissue samples from miners’ lungs have proven Wheeler wrong again and again. |
Frighteningly, it sounds like this guy has learned to give the expected answers on his four-year radiology recertification tests, but goes back to his whackjob views when diagnosing actual patients. The CPI showed him the *standard x-rays*, the black lung type specimen, that he diagnosed successfully on these tests, but told him it was from a miner; he diagnosed it as not black lung.
It sounds like:
a) This doctor has a non-medical belief that black lung somehow "ought to" be very rare, so he diagnoses it rarely.
b) He seems to think of a Type I error (giving a black lung award to a miner without black lung) is a horrible injustice, and he seems utterly unbothered about Type II errors (failing to diagnose a real black lung case). So he's constructed his fake diagnostic criteria to deliver pure Type II errors all the time, guaranteeing his freedom from the sin of a Type I.
c) He's generally a pompous moron and scumbag.
via JREF Forum http://forums.randi.org/showthread.php?t=268175&goto=newpost
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