Why demonstrating matters, and why you should be wary of using an iPhone for clinical calculations

by reestheskin on 11/04/2014

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Terrific article by Harold Thimbleby on IT and safe healthcare, and how they often do not work together. We don’t assess IT well, and forget how it can distort clinical care in ways that are often not apparent. Managers like it because it so often offers to cut costs, but some of the ways it does this is by lowering the standards of clinical care. The consumers of healthcare it seems  are not so much the patients, but the hospital finance officers.

Anyway, the teaching point, is the power of an example, and more so, of a demonstration. At one time science specialised in demonstrations because they have the power to overcome prejudice and outright scepticism in a way that little else will. They may be harder to do in modern  medicine, but software (ironically) offers enormous opportunities for doing this, and promoting deep learning.
The example —and demonstration— that stopped me in my tracks was:

“I live in Wales, and I am interested in what proportion of the world’s population is welsh. I therefore use a calculator to find out 3, 063, 500÷6, 973, 738, 433, which is the population of Wales divided by the population of the world (being numbers I got off the web so they must be right). Remember that you use a calculator because you do not know what the right answer is. Here, I obtain the following results (ignoring least significant digits):
Casio HS-8V 0.04 .
Apple iPhone portrait 0.004 . . .
Apple iPhone landscape 0.0004
If you didn’t know what the right answer is, you still don’t! These are all market-leading products, yet none of these calculators reports an error — only the last is correct. Whatever is going on inside the Apple iPhone, it could clearly report an error since it provides two different answers even if it doesn’t know is right!

The first electronic calculators appeared in the 1960s. We are no longer constrained by technology, and we’ve had some fifty years to get their designs right; it is hard to understand why calculators used in healthcare are not dependable.”

Well, both he and I are Welsh, but I still didn’t believe him. So, out with the iPhone and….he is right. Eppur si muove (to borrow from Galileo) . Do you use your iPhone for clinical calculations?

 

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