Doesn’t it just make sense?

Using a clinical decision rule should decrease the amount of head CT’s that are done.

Isn’t that why there are decision rules anyway?

Who would be crazy enough to publish a decision rule that increased utilization?

Only one of the biggest, most used rules called PECARN.

Very rarely do we compare what we are working on what a regular doctor is going to do anyway.

Just because it makes sense doesn’t mean that it works.

Measure something that matters

Wouldn’t you be ecstatic if your product reduces bleeding?

You could write huge headlines, “We reduce massive postoperative bleeding by 20%.”

This would be a huge win.

But what if it increased death by 50%?

Would it be worth it?


“This doesn’t really happen though,” you might say.

But it did. (

In Health IT we often focus on and promote surrogate outcomes (clicks, likes, engagement, bleeding) … the so called disease oriented outcomes.

But little do we study patient oriented outcomes like death and morbidity.

Maybe it is time?