Data and Donuts is having a birthday. It slipped my mind until I logged onto LinkedIn on my mobile device. It went crazy with canned, albeit hopefully sincere, congratulatory messages. A few colleagues wrote personal notes that were extremely heartfelt and reminded me of why I took on the challenge.
You might be asking the same question. I broke away from the pack because I felt something was missing. One on one conversations conveyed an urgency and frenetic energy around change. The healthcare system was evolving and more seats pulled up to the table. But where was the collective voice? The thiefdoms persisted. The cliques persisted. And the emperor(s) still prance around without any clothes.
If I had a theme for my interests last year, I would claim networks. When presented with a problem, an evaluation of meta-analyses or published system reviews allow you to investigate different pathways, data sources, and measure for yourself the rigor behind an outcome or a conclusion.
This graphic from Assessment of the Relative Effectiveness and Tolerability of Treatments of Type 2 Diabetes Mellitus: A Network Meta-analysis displays a network of direct comparisons of multiple-treatment meta-analyses for patient outcomes at HbA1c goal. The thicker the line the more direct comparisons were available for review. The colored nodes also vary in size proportional to the number of clinical trials completed for each treatment. There is a supplement resource that describes the treatments for each node. T5 is insulin...
A network is complicated. I write about topics in diabetes only second to oncology or Alzheimer's Disease. I mention the complexity of the network for many reasons. Probably the main reason is to help illustrate how silly it is to contract a writer to create an educational program or analyses based on what you hope to find.
It doesn't work that way. If we are truly vested in healthcare, and making a difference, we need to conduct the research first. Identify the gaps that float to the service--not the ones aligned with funding opportunities or "heavy peaches".
I create a flowchart for every presentation or report I develop in healthcare. I like collaborators to understand the complexity and time spent acquiring and consuming knowledge, amount of information possessed and quality of related content. When planning your research, article, presentation, or educational program--begin with a network. Linear thinking no longer applies. Use the graphic below as a template. Make it better.
Newer therapies don't exist in a vacuum and neither do your patients.
Connect your own dots.
Thoughtful discussions about content development and outcomes analytics that apply the principles and frameworks of health policy and economics to persistent and perplexing health and health care problems.
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Thank you for making a donution!
In a world of "evidence-based" medicine I am a bigger fan of practice-based evidence.
Remember the quote by Upton Sinclair...
“It is difficult to get a man to understand something, when his salary depends upon his not understanding it!”
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