Misleading direction

The European Commission s report eHealth for Safety summarises that In the case of clinical and organisational decision support systems, internationally, there are over two decades of sound evidence on their benefits [12]. Indeed, large numbers of healthcare organisations are turning to electronic decision support systems to forge consistency in care provision and develop best practice particularly in prescribing. But where clinicians become reliant on decision support to deliver safe clinical care, it is a short step to harm occurring when these systems are found to 

The risk associated with hazards in this area is often a function of the extent to which the human user has the ability to apply clinical judgement and disregard the suggested direction. For example, where a system passively presents a prescriber with the known side effects of a drug, he/she is able to make an informed decision on the pharmacological pros and cons. But where a system behaves in an automatic manner, perhaps restricting access to certain drugs which the system believes to be inappropriate, the potential for user intervention (and therefore human factor controls) is reduced. 

Hazards and issues relating to decision support include the potential for  

Note that unlike many other causes of clinical risk, the failure modes in this category do not actnally relate to the patient s clinical data at all. Instead it is the decision support content, rnles, algorithms and associated functionality which trigger the hazard. Controls in this area are not just about assuring the system but also about make sure that the advice provided is of a suitable level of quality. In some cases the decision snpport content and rules might be provided by a third party and checks should be undertaken to ensure that the information is appropriately governed, com-mensnrate with best practice and kept up to date. 

Clinicians needs systems which are dependable snch that they can place trust in them. Dependability encompasses availability, reliability and maintainability. Canses and failnre modes represent the variety of ways in which hazards can be triggered and they arise from many different sonrces. 

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All information, claims and graphic representations provided to healthcare professionals and members of the general public must be current, accurate and balanced, and must not mislead directly, by implication or by omission. 

They must not mislead directly or by implication, or by distortion, exaggeration or undue emphasis. 

The procedure in setting up this theory is based on a formal structural similarity between statistical physics and sociology, as explained above. This similarity, however, is not at all due to any (misleading) direct similarity between units, interactions and variables of physical and sociological systems, but is a consequence of the general probabilistic laws governing the statistical dynamics of multi-component systems ... 

Let us consider the manufac ture of metal ornaments. The processing cost, exclusive of material, may vaiy veiy httle for a wide range of materials. However, the direct materials cost will be much greater for precious than for base metals. In this case, an overhead allocation on the basis of direct material costs could be veiy misleading, while one based on direct labor cost could be quite accurate. 

In this paper we amplify Powell s discussion, which is in some respects misleading. For example, Powell made the following statement Unlike the familiar four-lobed cubic d orbital, the pyramidal d orbital has only rather inconspicuous lobes of opposite sign. Each orbital is not quite cylindrically symmetrical about its own axis of maximum probability. In fact, the pyramidal d orbital that he discusses in detail is far from cylindrically symmetrical about its own axis of maximum probability, and the other pyramidal d orbital is also far from cylindrically symmetrical. In the equatorial plane about the axis of maximum probability the functions of Powell s first set (which we shall call II) vary from —0.3706 in two opposite directions to —1.7247 in the orthogonal directions. Each of these functions has almost the same value (strength) in the latter directions as in the principal directions, for which its value is 2.0950. The functions of the other set (which we call I) vary in this plane from —0.7247 to —1.4696, their value in the principal direction being 2.1943. 

TEM is still the most powerful technique to elucidate the dispersion of nano-filler in rubbery matrix. However, the conventional TEM projects three-dimensional (3D) body onto two-dimensional (2D) (x, y) plane, hence the structural information on the thickness direction (z-axis) is only obtained as an accumulated one. This lack of z-axis structure poses tricky problems in estimating 3D structure in the sample to result in more or less misleading interpretations of the structure. How to elucidate the dispersion of nano-fillers in 3D space from 2D images has not been solved until the advent of 3D-TEM technique, which combines TEM and computerized tomography technique to afford 3D structural images, incidentally called electrontomography . 

Characterization of THIP at OC1P2Y2S receptors is therefore not predictive of the activity in vivo and may be directly misleading when it comes to addressing the potential for interaction with the benzodiazepines. 

This work suggests that the application of laboratory-derived results directly to natural conditions could, in these cases, be misleading analytical results for day ten if extrapolated directly might lead to the conclusion that natural methylmercury levels and rates of methylation are much greater than in fact they really are. Work in this area with model or laboratory systems needs to be interpreted with particular caution. 

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