John E Brush, MD

All posts by John E Brush, MD

September 5th, 2011

Base-Rate Neglect: A Common Clinical Fallacy

Estimating probabilities subjectively can lead to indiscriminate testing.

August 25th, 2011

“Numbers Traps” in Clinical Practice

As we make clinical decisions every day, we assess probabilities in a subjective fashion. And in doing so, we tend to fall into very predictable traps — traps we can get better at avoiding if we learn about how they ensnare us. That requires familiarizing ourselves with a bit of history. Several decades ago Casscells and […]

August 17th, 2011

How Cardiologists Think

Today on CardioExchange, we launch a new mini-series of blog posts on decision making in cardiology. Dr. John E. Brush explores the conscious and unconscious mental strategies that cardiologists use in their everyday work and asks you to examine your own decision-making processes. The aim: to foster a rich dialogue about how we do what we […]

February 17th, 2011

Unreasonable Expectations for Quality Improvement

At a recent committee meeting, my hospital’s administration announced new quality measures and targets. Striving for top performance, the board of the hospital system set the bar extraordinarily high. The bonuses of senior management are tied to achieving the targets, so the announcement had everyone’s attention. One target that caught my interest was for achieving a […]

December 23rd, 2010

John Brush: Looking Back at 2010 and Ahead to 2011

To celebrate the holiday season, CardioExchange asked several of our contributors to choose the 3 most important cardiology-related events of the past year and to make 3 predictions for 2011. Looking back at 2010: 1. The PARTNER Trial demonstrated the efficacy of transcatheter aortic valve implantation for patients deemed too high risk for conventional cardiac surgery.  This intervention […]

November 8th, 2010

Up-Front Clopidogrel Loading Versus Common Sense

From time to time, a sales representative visits my office promoting clopidogrel (Plavix) as a drug that patients who present with unstable angina/non–ST-segment-elevation MI (UA/NSTEMI) should start immediately as an up-front load. That strategy hasn’t been uniformly accepted in my clinician community because of concern about using an irreversible antiplatelet agent to treat patients who […]