Hospital Profiling: Is Healthgrades the Answer?

In a word, no. Let’s take a look at their most recent rankings. According to Healthgrades’ America’s Top 50 Hospitals list, not a single medical school-based university hospital made the cut. This means that either Healthgrades or the list recently published by
US News and World Report must be completely wrong, since their two lists are mutually exclusive. While I am not so sure US News has it right either, I think I’d take my chances with their top 14 over any of the top 50 listed by Healthgrades.

If you look at Healthgrades ratings by state, you will find some interesting results. Let’s take Maryland for example. There is no question that Johns Hopkins is the best hospital in Maryland and certainly one of the finest in the country. But not according to Healthgrades. Of 20 possible specialty excellence award categories, Johns Hopkins was ranked as one of the top hospitals in Maryland in exactly one, prostatectomy. For fun, search your state and see what turns up.

There is a paucity of scientific research on Healthgrades with very few citations in PubMed. An article published in JAMA in 2002 appears to still be valid today. From the abstract: “Hospital ratings published by a prominent Internet health care quality rating system identified groups of hospitals that, in the aggregate, differed in their quality of care and outcomes. However, the ratings poorly discriminated between any 2 individual hospitals' process of care or mortality rates during the study period. Limitations in discrimination may undermine the value of health care quality ratings for patients or payers and may lead to misperceptions of hospitals' performance.”

A 2005 paper raised questions about Healthgrades’ use of administrative databases to define quality of outcomes. The authors concluded: “Substantial variability of reported outcomes is seen in administrative data sets compared with an audited clinical database in the end points of the number of procedures performed and mortality. This variability makes it challenging for the nonclinician unfamiliar with outcomes analysis to make an informed decision.”

There are some other notable issues with Healthgrades. It is not widely known that they offer consulting services. These are promoted as helping hospitals achieve better quality but may be somewhat ethically challenging. It would be like a gymnastics judge charging for advice on how a gymnast could improve her score at the next Olympics. Would it not be in the best interest of the judge to have said gymnast’s score be better?

While we’re on the subject of ethics, Googling Healthgrades yields an interesting finding on the first page of hits: a web site voicing consumer complaints. The majority of these numerous complaints detail Healthgrades’ practice of charging a fee for a report on a doctor or hospital, which is of course OK. What’s not OK is that they sometimes tack on a monthly “watchdog” fee, which is billed to the consumer’s credit card, in what the consumers claim is a hidden charge that they did not agree to. And it is difficult to have the extra charges removed and refunded.

In case you think this is not big business: Healthgrades has apparently just been purchased by another company for $294 million dollars. But even this deal is coming under fire as some shareholders feel that the company was underpriced. An investigation is under way.

So how does one pick a good hospital? I would say find a doctor you trust, ask for recommendations and do your own research. But I would take all ranking systems with a large grain of salt.


Source: http://skepticalscalpel.blogspot.in/2010/08/hospital-profiling-is-healthgrades.html

Website Data Scraping Are Relatively Easy To Use

Have you ever heard "data scraping?" Scraping data scraping technology to new technology and a successful entrepreneur made his fortune by taking advantage of the data is not.

Sometimes the owner of the website automatically harvest your data will not be much fun. Webmaster tools or techniques contained in the website retrieving block certain IP addresses from using their websites to disallow web scrapers learned to use. The all eventually left may be blocked.

Venus is a modern solution to the problem. Proxy data scraping technology solves this problem by using proxy IP addresses. Each time you scraping the data the program execute an exit from a website, website think it is coming from a different IP address. The owner of the website, the proxy data scraping a short period of increased traffic from all over the world look like.

Now you might ask yourself, "do I get for my project in which the data scraping technology Proxy?" "Do it yoursel f" solution, but unfortunately, not all madly. Hindi to mention. The proxy server you choose to rent consider hosting provider, but somewhat pricey option, but certainly better than the alternative would be incredibly dangerous (but) free public proxy server.

There are literally thousands of free proxy servers located all over the world that are relatively simple to use. But finding it misleading. Many sites list hundreds of servers, but that's hard to find, open, and support the type of protocol you need patience, trial and error, can be a lesson. But if you're working behind the scenes to the public in finding a pool is not successful, there is still the inherent risk of using it. First, you do not know which server belongs to or what the task of going to a server in one place. Through a public proxy requests or to transmit sensitive data is a bad idea.

Proxy data scraping for a less risky situation is to rent a rotating proxy connection to cycle thro ugh a large number of private IP addresses. Company as large anonymous proxy solutions, but often carry a pretty hefty setup fee to get going.

After performing a simple Google search, I quickly that the purposes scraping anonymous company that provide access to data in the proxy server.
The proxy server you choose to rent consider hosting provider, but somewhat pricey option, but certainly better than the alternative would be incredibly dangerous (but) free public proxy server.

Some challenges will be to:

Block IP address: If you continue to keep your office scraping a website, your IP "security guard" From day one is blocked.

Unless you are an expert in programming, you will not be able to receive data.

In today's society of natural resources, its users a service that is still delivering fresh data it is moving.

Source: http://enewcomers.blogspot.in/2013/04/website-data-scraping-are-relatively.html

Oklahoma Dentist Disciplinary Database

A lot of media publicity has occurred regarding a case that appeared last month where patients of an oral surgeon in Oklahoma were asked to get tested for HIV and hepatitis after it was found that potentially lax sterilization procedures were used. More on this case is discussed over at Dental Patients Warned of Possible HIV and Hepatitis Exposure Due to Oral Surgeon’s Practices for example.

The Tulsa World has been prompted to publish a searchable database of all disciplinary actions taken against dentists, in the state of Oklahoma from January 2000, to January 2013, after the case involving lax sterilization procedures came to light. In that case one patient had four third molars (wisdom teeth) removed and was allegedly given sedation by a dental assistant who should not have been giving sedation. She later developed an infection and liver problems.

The Tulsa Word seems to be publishing the database to allow patients to better research dentists and make determinations of who they may decide to see to perform their dental work. Most cases that involve disciplinary actions against a dentist by a State Board of Dentistry do not receive quite the amount of media scrutiny as the case did discussed previously.

A description of the Tusla World’s findings is in the article by Casey Smith and Ziva Branstetter titled “Sunday: 68 Oklahoma dentists disciplined since 2000, World finds,” published on April 27, 2013,  located over at http://www.tulsaworld.com/article.aspx/Sunday_68_Oklahoma_dentists_disciplined_since_2000/20130427_296_sunda_99885

The article states

    “The state agency responsible for disciplining dentists took at least 98 actions against dentists during that time for violations of the state dental act and other laws including substance abuse, improper prescribing practices and allowing assistants to perform work for which they were not licensed. Other circumstances involved dentists who violated the terms of their board probations, made improper sexual contact or remarks to patients, had misleading advertisements or took part in Medicaid fraud.”

Additional Source: DrBicuspid. “65 Okla. patients test positive for hepatitis C,” April 26, 2013, located at http://www.drbicuspid.com/index.aspx?sec=sup&sub=hyg&pag=dis&ItemID=313209

Source: http://blog.teethremoval.com/oklahoma-dentist-disciplinary-database/

1-800-DENTIST(R) launches Web site

1-800-DENTIST(R), the nation's most trusted resource for consumers in search of a dentist, has announced the launch of its online service at www.1800dentist.com. Since 1986, millions of consumers across the nation have dialed 1-800-DENTIST to find a dentist in their area. Now, consumers can also log on to 1800dentist.com for the same high-quality service and a referral to one of 1-800-DENTIST's pre-screened member dentists.

1800dentist.com is user-friendly and offers consumers step-by-step instructions on how to access the extensive online database to find a pre-screened dentist. To initiate the search, consumers are asked to:

-- Enter a complete address (for geographic matching).
-- Select a dental need (whitening, toothache, orthodontics, etc.).
-- Select a payment option.

After entering this information, 1800dentist.com's search engine returns a map highlighting a select group of practices located within the desired radius. From there, consumers can conduct further research through the "tell me more" option, which provides comprehensive background information on the selected dentist, including years in practice, education, current licenses, practice specialties (e.g. endodontics), special services (e.g. whitening), latest dental equipment, what type of sedation is available, and if the practice provides emergency treatment. From there, users can opt to request an appointment from the dental office of their choice.

With the launch of 1800dentist.com, 1-800-DENTIST hopes to expand its reach and become the trusted online resource for consumers in search of quality dental care in their area. 1-800-DENTIST actively supports and promotes the importance of including regular dental office visits as a part of every consumer's health-care regimen. 1-800-DENTIST commercials are aired on television 4,000 times each month, prompting an estimated 1.2 million people to call 1-800-DENTIST every year.

Source: http://www.dentistryiq.com/articles/de/2002/11/1-800-dentistr-launches-web-site.html