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Evidence That Cardiology Fellows Change Their Estimates to Become as Accurate as the Faculty

Lee Goldman, MD, MPH; Christine Waternaux, PhD; Francis Garfield, PhD; Peter F. Cohn, MD; Robert Strong, PhD; William H. Barry, MD; E. Francis Cook, ScD; Robert Rosati, MD; Herbert Sherman, DEE

Arch Intern Med. 1981;141(12):1631-1634.

Abstract
• To determine whether physicians would be influenced by the prognostic information in a large coronary artery disease data bank, cardiology faculty and fellows made initial estimates of the prognoses of their patients and then made revised final estimates after seeing the outcome of matched patients (OMP) from the data bank. The faculty cardiologists' original estimates proved to be as accurate as those of the data bank's OMP, and the faculty revised their estimates minimally in response to the data bank's OMP. Conversely, the cardiology fellows' original estimates were less accurate than the data bank's OMP, and under all observed circumstances the fellows responded more to the data bank's OMP than did the faculty. As a result, the accuracy of the fellows' final estimates was similar to the accuracies of both the faculty cardiologists and the data bank's OMP. Computerized data banks seem more likely to have impact when their information is provided to physicians who are relatively inexperienced with the disease in question.

(Arch Intern Med 1981;141:1631-1634)

Author Affiliations
From the Divisions of Cardiology (Drs Goldman, Cohn, and Barry) and General Medicine (Drs Goldman and Garfield), Peter Bent Brigham Hospital, Boston; Center for the Analysis of Health Practices (Drs Strong and Sherman) and the Departments of Biostatistics (Dr Waternaux) and Epidemiology (Dr Cook), Harvard School of Public Health, Boston; and Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, NC (Dr Rosati). Dr Goldman is the recipient of a Teaching and Research Scholarship, American College of Physicians.

Footnotes
Accepted for publication Nov 13, 1980.

Reprint requests to Department of Medicine, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 (Dr Goldman).

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