{"id":2734,"date":"2020-07-28T01:00:59","date_gmt":"2020-07-28T07:00:59","guid":{"rendered":"https:\/\/www.qimacros.com\/lean-six-sigma-blog\/?p=2734"},"modified":"2021-06-21T10:40:00","modified_gmt":"2021-06-21T16:40:00","slug":"mammograms-are-a-type-of-inspection","status":"publish","type":"post","link":"https:\/\/www.qimacros.com\/lean-six-sigma-blog\/mammograms-are-a-type-of-inspection\/","title":{"rendered":"Mammograms are a Type of Inspection"},"content":{"rendered":"\r\n<p>Breast Cancer is Rare, yet we subject women to mammograms to try to detect it. False positives are 20X higher than true positives. Deming said: &#8220;Cease dependence on inspection to achieve quality.&#8221;<\/p>\r\n\r\n\r\n\r\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/400943904?title=0&amp;byline=0&amp;portrait=0\" width=\"720\" height=\"405\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><span data-mce-type=\"bookmark\" style=\"display: inline-block; width: 0px; overflow: hidden; line-height: 0;\" class=\"mce_SELRES_start\"><\/span><\/iframe><\/p>\r\n\r\n\r\n\r\n<p>&#8220;Hi, I\u2019m Jay Arthur, author of \u201cLean Six Sigma Demystified,\u201d \u201cLean Six Sigma for Hospitals,\u201d and the QI Macros [software].<\/p>\r\n<p>&#8220;I found another interesting item in Malcolm Gladwell&#8217;s book; again, it was in the back notes. They were talking about mammograms. Breast cancer itself is really rare, it&#8217;s like less than a half of 1% of women who get a mammogram actually have cancer, so it&#8217;s like looking for a needle in a haystack. What epidemiologists know is that if you gave a mammogram to 100,000 women it would probably find maybe 400 of the 500 women who have cancer. It would miss a hundred. (No, these are not exact numbers, but I&#8217;m really close here. I&#8217;m just making it simple.)<\/p>\r\n<p>&#8220;So what does that mean? Well, 400 women get diagnosed, 100 women are missed and that&#8217;s a problem, right there. My friend Janet &#8211; the doctors missed hers and she thought she had it and she beat on her doctor, [who said] &#8220;Well, you don&#8217;t have it.&#8221; Well, yes she did and she died. I want you all to be cautious. These false negatives are as bad as the false positives, but the false positives is another interesting story.<\/p>\r\n<p>&#8220;In that same 100,000 women with mammograms, 9,000 get false positives, and what does that mean? Well, that means they probably have to have a needle biopsy and have that tested, and worry like crazy and that&#8217;s $10,000 plus a shot to get a needle biopsy and be terrified. It takes a week or more to get the biopsy results. That&#8217;s an awful lot of fear forced on 9,000 women so that we can detect 400 or 500 cancers. If you&#8217;re the one who should have been tested and wasn&#8217;t tested, that&#8217;s another story.<\/p>\r\n<p>&#8220;What I think Gladwell says is, are you more concerned about the risk of a tiny chance that you&#8217;ll have cancer that will be missed or a much larger probability that you&#8217;ll be misdiagnosed with a cancer you don&#8217;t have?<\/p>\r\n<p>&#8220;Deming (and I don&#8217;t usually quote Deming) Deming said \u201cCease forever the process of inspection.\u201d Mammograms are a type of inspection. We&#8217;re looking for defects, right? Can&#8217;t we find a better way? Isn&#8217;t there a better way to do this than to subject all these women to unnecessary mammograms? Again, that&#8217;s a cost, right? It&#8217;s all inspection. I know you&#8217;ve done it that way for a long time, but isn&#8217;t there a better way? Why can&#8217;t we get smarter? Why can&#8217;t we find better answers?<\/p>\r\n<p>&#8220;That&#8217;s my Improvement Insight for this week: Cease the process of inspection. That&#8217;s true in your manufacturing plant, it&#8217;s true in your hospital, it&#8217;s true in your life&#8230; &#8230;if you can.<\/p>\r\n<p>&#8220;I\u2019m Jay Arthur. Let&#8217;s go out and improve something this week.&#8221;<\/p>\r\n","protected":false},"excerpt":{"rendered":"<p>Breast Cancer is Rare, yet we subject women to mammograms to try to detect it. False positives are 20X higher than true positives. Deming said: &ldquo;Cease dependence on inspection to achieve quality.&rdquo; &ldquo;Hi, I&rsquo;m Jay Arthur, author of &ldquo;Lean Six Sigma Demystified,&rdquo; &ldquo;Lean Six Sigma for Hospitals,&rdquo; and the QI Macros [software]. &ldquo;I found another [&hellip;]<\/p>\n","protected":false},"author":4,"featured_media":4748,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[290],"tags":[299,48,118,168,140,158,170],"class_list":["post-2734","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-improvement-insights","tag-deming","tag-insights-tagged-as-healthcare","tag-lean-six-sigma","tag-qi-macros","tag-quality-improvement","tag-quality-tools","tag-six-sigma"],"_links":{"self":[{"href":"https:\/\/www.qimacros.com\/lean-six-sigma-blog\/wp-json\/wp\/v2\/posts\/2734","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.qimacros.com\/lean-six-sigma-blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.qimacros.com\/lean-six-sigma-blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.qimacros.com\/lean-six-sigma-blog\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/www.qimacros.com\/lean-six-sigma-blog\/wp-json\/wp\/v2\/comments?post=2734"}],"version-history":[{"count":5,"href":"https:\/\/www.qimacros.com\/lean-six-sigma-blog\/wp-json\/wp\/v2\/posts\/2734\/revisions"}],"predecessor-version":[{"id":3882,"href":"https:\/\/www.qimacros.com\/lean-six-sigma-blog\/wp-json\/wp\/v2\/posts\/2734\/revisions\/3882"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.qimacros.com\/lean-six-sigma-blog\/wp-json\/wp\/v2\/media\/4748"}],"wp:attachment":[{"href":"https:\/\/www.qimacros.com\/lean-six-sigma-blog\/wp-json\/wp\/v2\/media?parent=2734"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.qimacros.com\/lean-six-sigma-blog\/wp-json\/wp\/v2\/categories?post=2734"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.qimacros.com\/lean-six-sigma-blog\/wp-json\/wp\/v2\/tags?post=2734"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}