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The story of Doctor Kim A. Adcock’s approach to solving a problem in the radiology department at Kaiser Permanente in Denver reads like script background for one of those “procedural” TV shows such as CSI. We know who died (far too many) and we know who did it (doctors, sort of) but we’re not sure how to handle the evidence to make sure nobody gets killed next time.

Procedures that seemed reasonable to Kaiser in 1995 because they “had always been done that way,” turned out to be entirely unreasonable, with deadly consequences. And a solution that seemed impossible because of fear, turned out to be the best and most logical of solutions, and has saved countless lives.

Microsoft PowerPoint - EKA.RSNApressimages.2012.10.08.pptxMicrosoft PowerPoint - EKA.RSNApressimages.2012.10.08.pptx

[Caption above and below:Mammography images (from 2010, left; and 2012, right) of a woman in her forties with no family history of breast cancer who missed a year of screening and in the interval developed suspicious right upper out calcifications [ ] and a suspicious mass { }, both of which underwent biopsy, yielding invasive carcinoma.]

Microsoft PowerPoint - EKA.RSNApressimages.2012.10.08.pptxMicrosoft PowerPoint - EKA.RSNApressimages.2012.10.08.pptx

I read this story when it first appeared in 2002 and have cherished its insights ever since. Now 13 years later, I had to go find it to share it with this class. Since reading it, and other stories like it, I cannot look at statistics of any kind without wondering what they really mean. If the crime rate goes down, does that mean there is less crime? Maybe not. It might mean fewer people are reporting crimes.

For example, in New Orleans after Katrina, distrust of the police ran so high most citizens in some neighborhoods preferred to suffer crime in silence than to involve the police. The very first thought that came to my mind listening to that story was, “I’ll bet the crime rate has gone down in those neighborhoods” and not because there’s less crime. The mayor though, and the chief of police, can trumpet those statistics as if they’re doing a better job in those same neighborhoods.

But I digress. Before you read the article, “Mammogram Team Learns From Its Errors,” I want you to make predictions on a variety of factual situations that lend themselves to counterintuitivities. (I’m going to keep using this word until the rest of the world adopts it.)

Open the post E08: Counterintuitive Predictions and react to the 50 claims by making a long Reply below the post. When you finish classifying the 50 claims, try to summarize the article you’ve never read based on the claims you find in the list.

Photo Source: Radiologic Society of North America RSNA