Decision Analysis – Reward Health

Decision Analysis

U of Michigan study: Epic’s sepsis predictive model has “poor performance” due to low AUC, but reporting AUC is like building a bridge half way over a river. How to finish the job.

The Epic Sepsis Model (ESM) is a widely used proprietary predictive model that was described as having poor performance in a validation paper by Wong et al, citing low area under the ROC curve (AUC). But the evaluation failed to specify the intended protocol in which the ESM was intended to be used, and failed to include estimates of the outcomes of that protocol compared to usual care.

Dr. Ward August 29, 2021 7 Comments

ACO Culture

To resolve conflicts, re-frame polar positions as optimization between undesirable extremes. But, sometimes there is no way to win.

In politics and professional life, achieving success requires the ability to resolve conflicts. I’ve noticed that conflicts often become entrenched because the opposing parties both

Dr. Ward February 18, 2012 3 Comments

ACO Culture

Reports of the death of Cost-Effectiveness Analysis in the U.S. may have been exaggerated: The ongoing case of Mammography

Guidelines for the use of mammograms to screen for breast cancer have been the topic of one of the fiercest and longest-running debates in medicine.

Dr. Ward August 13, 2011 No Comments

ACO Reimbursement and Gain Sharing

NEJM report of ACO financial model fails to include risk of delayed start on transformation

On March 23, 2011, Trent Haywood, MD, JD, and Keith Kosel, PhD, MBA published the results in the New England Journal of Medicine (NEJM) web

Dr. Ward March 30, 2011 3 Comments

Continuous Quality Improvement (CQI)

The Smoking Intervention Program, a Provider-based Care Management Process

Smoking cessation is an important public health concern, and has been the subject of a recent Agency for Health Care Policy and Research (AHCPR) guideline,

Dr. Ward January 28, 2011 No Comments

Clinical Practice Guidelines and Protocols

Using Eddy’s Explicit Method to Develop Practice Guidelines for Mammography in the 40-49 Age Group

Note that the following write-up is now almost 20 years old! (How did that happen?) Amazingly, the debate about the role and frequency of mammography

Dr. Ward January 27, 2011 3 Comments