Seeing the same GP six weeks later sounds like something out of a different era but this is a very interesting post...
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@jtonline
Sorry, I got stuck on the fourth paragraph, where he says "Let me not be ungenerous to the tools themselves. The clinical governance around the particular tool used, is genuinely solid.... A large US study published in JAMA found that ambient scribing reduced clinician burnout from 51.9% to 38.8% after just thirty days of use."
I have read that paper. It was a quality improvement study with no control group, volunteers who opted in to trying the tech, and 263 of the volunteers filled out the pre- and post-implementation survey and used it in non-emergency room consultations. But wait, "Site 5 (which included 63 participants) did not include survey burnout questions and so was censored from the primary outcome" - so: the burnout finding is based on 200 participants."Large study" "ungenerous" "genuinely solid" ROTFL
@jtonline
Personally, I would record the fact that 63 of my 263 survey respondents answered a version of my survey that didn't have the questions about THE PRE SPECIFIED PRIMARY OUTCOME in the study participant flowchart (not just the narrative of the methods section)
But frankly I wouldn't consider a 263-participant analysis to be "a large study" either so maybe it doesn't matter for the purpose of evaluating the blog post -
@jtonline
Personally, I would record the fact that 63 of my 263 survey respondents answered a version of my survey that didn't have the questions about THE PRE SPECIFIED PRIMARY OUTCOME in the study participant flowchart (not just the narrative of the methods section)
But frankly I wouldn't consider a 263-participant analysis to be "a large study" either so maybe it doesn't matter for the purpose of evaluating the blog postActually it is worse than I noticed the first time I read the paper. I'm not really clear how they got down to 186 respondents with burnout info (the PRIMARY OUTCOME I remind myself). The difference between the 200 number that I expected and the 186 whose data is included is bigger than the number of respondents whose data is excluded because they did <5 consultations with the ambient scribe. Did some respondents skip those questions maybe? Too bad the participant flowchart doesn't say. But at least this statement is pretty clear:
"Among 186 participants included in the burnout models," -
Actually it is worse than I noticed the first time I read the paper. I'm not really clear how they got down to 186 respondents with burnout info (the PRIMARY OUTCOME I remind myself). The difference between the 200 number that I expected and the 186 whose data is included is bigger than the number of respondents whose data is excluded because they did <5 consultations with the ambient scribe. Did some respondents skip those questions maybe? Too bad the participant flowchart doesn't say. But at least this statement is pretty clear:
"Among 186 participants included in the burnout models,"The time savings bit that the blogger-physician called "striking" and gave at 26%, I am not sure how to interpret that part of the study.
From the paper:
"reduce time spent documenting after hours (mean [SE] difference, 0.90 [0.19] hours; P < .001)"
Table: afterhours documentation time from 4.95 to 4.05 - not clear what the units are. Maybe minutes per consultation?
"Our participants reported the equivalent of 10.8 minutes saved per workday after intervention. "
"These factors may explain why scribe-assisted encounter documentation is associated with only modest time savings, highlighting the need for future support of additional EHR tasks."
"Despite these small changes in documentation time, the significant change in burnout suggests that these small improvements may have an outsized influence or that other aspects of the intervention may improve overall clinician experience."Author call the time savings "modest" and "small". Blogger-physician calls them "striking".
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The time savings bit that the blogger-physician called "striking" and gave at 26%, I am not sure how to interpret that part of the study.
From the paper:
"reduce time spent documenting after hours (mean [SE] difference, 0.90 [0.19] hours; P < .001)"
Table: afterhours documentation time from 4.95 to 4.05 - not clear what the units are. Maybe minutes per consultation?
"Our participants reported the equivalent of 10.8 minutes saved per workday after intervention. "
"These factors may explain why scribe-assisted encounter documentation is associated with only modest time savings, highlighting the need for future support of additional EHR tasks."
"Despite these small changes in documentation time, the significant change in burnout suggests that these small improvements may have an outsized influence or that other aspects of the intervention may improve overall clinician experience."Author call the time savings "modest" and "small". Blogger-physician calls them "striking".
Wait. *Now* I am rolling on the floor laughing. What I was doing before was a mere chuckle compared to this
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Wait. *Now* I am rolling on the floor laughing. What I was doing before was a mere chuckle compared to this
Btw even the amended version says "large US study published in JAMA" that was actually published in the much less selective journal JAMA Network Open
And describes several papers as "PMC" papers, as if PMC were a journal with editorial processes and a reputation, rather than a green open access platform
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Wait. *Now* I am rolling on the floor laughing. What I was doing before was a mere chuckle compared to this
@nyhan that did make me chuckle too
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@nyhan that did make me chuckle too
@jtonline it might explain where he came up with the 26% time savings claim, which I can't find anywhere in the article
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Seeing the same GP six weeks later sounds like something out of a different era but this is a very interesting post...
I Was an Enthusiastic Early Adopter of AI Scribes. Here’s Why I Stopped
A GP reflects on what eighteen months of ambient scribing taught them about the consultation they thought they already understood.
(benngooch.substack.com)
@jtonline
My partner & I had 100 years combined care from a father & son GPs. Her children were also cared for until they left home. Partner, born in 1922, died in 2017 in home hospice and the doctor made house calls. -
Seeing the same GP six weeks later sounds like something out of a different era but this is a very interesting post...
I Was an Enthusiastic Early Adopter of AI Scribes. Here’s Why I Stopped
A GP reflects on what eighteen months of ambient scribing taught them about the consultation they thought they already understood.
(benngooch.substack.com)
@jtonline just gonna throw this out there "funny name, serious blog."
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Seeing the same GP six weeks later sounds like something out of a different era but this is a very interesting post...
I Was an Enthusiastic Early Adopter of AI Scribes. Here’s Why I Stopped
A GP reflects on what eighteen months of ambient scribing taught them about the consultation they thought they already understood.
(benngooch.substack.com)
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Wait. *Now* I am rolling on the floor laughing. What I was doing before was a mere chuckle compared to this
@nyhan Yeah, I got all the way to the end and saw that and felt disgusted and outraged that I'd wasted my time reading it.
It's another example of people saying, 'yeah, after careful consideration I've decided that AI is no good for my particular specialism, but for other things it's great!'
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R relay@relay.mycrowd.ca shared this topic
