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  3. Seeing the same GP six weeks later sounds like something out of a different era but this is a very interesting post...

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@mastodon.me.ukJ jtonline@mastodon.me.uk

    Seeing the same GP six weeks later sounds like something out of a different era but this is a very interesting post...

    Link Preview Image
    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.

    favicon

    (benngooch.substack.com)

    nyhan@fediscience.orgN This user is from outside of this forum
    nyhan@fediscience.orgN This user is from outside of this forum
    nyhan@fediscience.org
    wrote last edited by
    #2

    @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

    nyhan@fediscience.orgN 1 Reply Last reply
    0
    • nyhan@fediscience.orgN nyhan@fediscience.org

      @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

      nyhan@fediscience.orgN This user is from outside of this forum
      nyhan@fediscience.orgN This user is from outside of this forum
      nyhan@fediscience.org
      wrote last edited by
      #3

      @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

      nyhan@fediscience.orgN 1 Reply Last reply
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      • nyhan@fediscience.orgN nyhan@fediscience.org

        @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

        nyhan@fediscience.orgN This user is from outside of this forum
        nyhan@fediscience.orgN This user is from outside of this forum
        nyhan@fediscience.org
        wrote last edited by
        #4

        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,"

        nyhan@fediscience.orgN 1 Reply Last reply
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        • nyhan@fediscience.orgN nyhan@fediscience.org

          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,"

          nyhan@fediscience.orgN This user is from outside of this forum
          nyhan@fediscience.orgN This user is from outside of this forum
          nyhan@fediscience.org
          wrote last edited by
          #5

          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".

          nyhan@fediscience.orgN 1 Reply Last reply
          0
          • nyhan@fediscience.orgN nyhan@fediscience.org

            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".

            nyhan@fediscience.orgN This user is from outside of this forum
            nyhan@fediscience.orgN This user is from outside of this forum
            nyhan@fediscience.org
            wrote last edited by
            #6

            Wait. *Now* I am rolling on the floor laughing. What I was doing before was a mere chuckle compared to this

            Link Preview Image
            nyhan@fediscience.orgN jtonline@mastodon.me.ukJ ergative@wandering.shopE 3 Replies Last reply
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            • nyhan@fediscience.orgN nyhan@fediscience.org

              Wait. *Now* I am rolling on the floor laughing. What I was doing before was a mere chuckle compared to this

              Link Preview Image
              nyhan@fediscience.orgN This user is from outside of this forum
              nyhan@fediscience.orgN This user is from outside of this forum
              nyhan@fediscience.org
              wrote last edited by
              #7

              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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              • nyhan@fediscience.orgN nyhan@fediscience.org

                Wait. *Now* I am rolling on the floor laughing. What I was doing before was a mere chuckle compared to this

                Link Preview Image
                jtonline@mastodon.me.ukJ This user is from outside of this forum
                jtonline@mastodon.me.ukJ This user is from outside of this forum
                jtonline@mastodon.me.uk
                wrote last edited by
                #8

                @nyhan that did make me chuckle too 🙂

                nyhan@fediscience.orgN 1 Reply Last reply
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                • jtonline@mastodon.me.ukJ jtonline@mastodon.me.uk

                  @nyhan that did make me chuckle too 🙂

                  nyhan@fediscience.orgN This user is from outside of this forum
                  nyhan@fediscience.orgN This user is from outside of this forum
                  nyhan@fediscience.org
                  wrote last edited by
                  #9

                  @jtonline it might explain where he came up with the 26% time savings claim, which I can't find anywhere in the article

                  1 Reply Last reply
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                  • jtonline@mastodon.me.ukJ jtonline@mastodon.me.uk

                    Seeing the same GP six weeks later sounds like something out of a different era but this is a very interesting post...

                    Link Preview Image
                    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.

                    favicon

                    (benngooch.substack.com)

                    stevewfolds@mastodon.worldS This user is from outside of this forum
                    stevewfolds@mastodon.worldS This user is from outside of this forum
                    stevewfolds@mastodon.world
                    wrote last edited by
                    #10

                    @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.

                    1 Reply Last reply
                    0
                    • jtonline@mastodon.me.ukJ jtonline@mastodon.me.uk

                      Seeing the same GP six weeks later sounds like something out of a different era but this is a very interesting post...

                      Link Preview Image
                      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.

                      favicon

                      (benngooch.substack.com)

                      netraven@hear-me.socialN This user is from outside of this forum
                      netraven@hear-me.socialN This user is from outside of this forum
                      netraven@hear-me.social
                      wrote last edited by
                      #11

                      @jtonline just gonna throw this out there "funny name, serious blog."

                      1 Reply Last reply
                      0
                      • jtonline@mastodon.me.ukJ jtonline@mastodon.me.uk

                        Seeing the same GP six weeks later sounds like something out of a different era but this is a very interesting post...

                        Link Preview Image
                        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.

                        favicon

                        (benngooch.substack.com)

                        leadegroot@bne.socialL This user is from outside of this forum
                        leadegroot@bne.socialL This user is from outside of this forum
                        leadegroot@bne.social
                        wrote last edited by
                        #12

                        @jtonline @cstross i do wonder if this would be less impactive for different people - i wonder if this clinician is someone who “learns by writing down” and that has carried through in their professional career

                        1 Reply Last reply
                        0
                        • nyhan@fediscience.orgN nyhan@fediscience.org

                          Wait. *Now* I am rolling on the floor laughing. What I was doing before was a mere chuckle compared to this

                          Link Preview Image
                          ergative@wandering.shopE This user is from outside of this forum
                          ergative@wandering.shopE This user is from outside of this forum
                          ergative@wandering.shop
                          wrote last edited by
                          #13

                          @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!'

                          1 Reply Last reply
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