Enemy Of Good Research Articles

When Perfect Is the Enemy of Good: Results of a RAND Appropriateness Panel on Treat to Target in Asymptomatic Inflammatory Bowel Disease.

A treat-to-target strategy for inflammatory bowel disease (IBD) recommends iterative treatment adjustments to achieve clinical and endoscopic remission. In asymptomatic patients with ongoing endoscopic activity, the risk/benefit balance of this approach is unclear, particularly with prior exposure to advanced therapies. Using the RAND/University of California Los Angeles Appropriateness Method, 9 IBD specialists rated appropriateness of changing therapy in 126 scenarios of asymptomatic patients with ulcerative colitis and Crohn's disease and active endoscopic disease. Disease extent and behavior, prior treatment, prior complications, and recent disease progression were considered, as were factors that might influence decision-making, including age and pregnancy. Ratings were collected through anonymous survey, discussed at an in-person meeting, and finalized in a second anonymous survey. Panelists rated change in therapy as appropriate (i.e., expected benefit sufficiently outweighs potential harms from continuing therapy) in 96/126 scenarios, generally in patients with progressive, complicated, and/or extensive disease, while changing therapy was rated uncertain in 27 scenarios of mild and/or stable disease. Changing therapy was rated inappropriate in ulcerative colitis patients with mild and stable disease previously exposed to ≥3 therapies or with improved endoscopic activity, and in Crohn's disease patients with only scattered aphthous ulcers. The validated threshold for disagreement was not crossed for any scenario. Patient age older than 65 years and a plan for pregnancy in the next year might influence decision-making in some settings. Appropriateness ratings can help guide clinical decision-making about changing therapy to achieve endoscopic remission in asymptomatic patients with IBD until data from ongoing randomized studies are available.

Don't Let Perfect Be the Enemy of Good: A Proof of Concept for a Custom National Data Repository of Quality Measures for Free and Charitable Clinics.

Purpose:Free and charitable clinics (FCCs), nonprofits that utilize volunteer licensed health care professionals to provide health services at no cost or a small fee to low-income uninsured patients who are disproportionately from underrepresented communities, have been part of the safety net for over a century. Approximately 1400 known FCCs serve two million patients annually. Despite their longevity and sizable number, evidence regarding the quality of care in FCCs is lacking. We report new evidence generated by a national initiative, the Roadmap to Health Equity. Established in 2017, this consortium is co-led by two national organizations serving FCCs and an academic institution. It has involved more than 150 FCC stakeholders with the shared goal of improving the quality of care and reducing inequities. The centerpiece is a custom national data repository of 15 validated clinical quality measures and patient-level characteristics.Methods:Fifty FCCs pilot tested the data repository. Clinics submitted patient-level data on two blood pressure (BP) measures and at least one additional measure. Descriptive statistics were stratified by sex, race, ethnicity, and language.Results:In 2021, 33 pilot FCCs from 21 states reported data across 13 of the 15 clinical measures, representing 34,359 unique patients. For example, on average, 60% of patients had controlled BP, but Black patients had lower rates of BP control than Hispanic and White patients (55.9% vs. 62.1% and 63.0%, respectively).Conclusion:Our findings demonstrate a proof of concept. By standardizing quality measures alongside patient characteristics, clinics can become aware of racial/ethnic inequalities in health outcomes. This information can motivate clinics to investigate the causes and implement solutions. In an environment where outcome data from FCCs are scarce, the new national data repository lays the foundation for routine stratified reporting of a range of quality outcomes for an important safety net for the uninsured.

Don’t Let Perfect Be the Enemy of Good: Why Point-of-Care Testing in Resource-Poor Countries Is Feasible and Reasonable

Don’t Let Perfect Be the Enemy of Good: Why Point-of-Care Testing in Resource-Poor Countries Is Feasible and Reasonable

Face masks and COVID-19: don't let perfect be the enemy of good.

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When Perfect is the Enemy of Good - Quality and Sustainability in Digitization Processes

Machine Learning and IIIF are popular topics today when it comes to digitisation projects and digital humanities. But are these really practical topics or just buzzwords? Are these rather exclusive technologies of some elite cultural and research institutions? Or can everyday digitisation projects with less exquisite materials really benefit from such technologies? The example of the community around the open source software Goobi shows what the reality of numerous digitisation projects really looks like. What is no longer just theory and can be used in everyday life without having to develop software yourself? And what added value can actually be expected here?

Best is the Enemy of Good: Design Techniques for Low Power Tunable Approximate Application Specific Integrated Chips Targeting Media-Based Applications

Best is the Enemy of Good: Design Techniques for Low Power Tunable Approximate Application Specific Integrated Chips Targeting Media-Based Applications

Perfect is the Enemy of Good: Going to the War on Cancer with Less Evidence than We Could Have

AbstractRandomized controlled trials have been the mainstay of high-level evidence for or against cancer screening strategies. However, simple proof of reduction in cause-specific mortality is not enough for policymaking, particularly in the last 10 years. Today’s clinical and public health guidelines take into account the balance of risks to benefits from screening, costs, utilities, the political risk of inaction, the societal tolerance to risk, healthcare providers’ preferences, client choices, and other imponderables or subjective variables that cannot be captured or addressed via epidemiologic studies. This commentary uses the above perspective in discussing Miettinen’s arguments concerning the science of breast cancer screening.

When Better Is the Enemy of Good

When Better Is the Enemy of Good

The Enemy of Good Is Perfect

The Enemy of Good Is Perfect

Excellence is the Enemy of Good.

Excellence is the Enemy of Good.

Perfect Is the Enemy of Good: The Iranian System of Paid Donation

Perfect Is the Enemy of Good: The Iranian System of Paid Donation

Oxygen: when is more the enemy of good?

Oxygen: when is more the enemy of good?

Better Is the Enemy of Good

Better Is the Enemy of Good

T1566 Comparison of the Conventional Manometry and High Resolution Manometry in the Assessment of the Resting Characteristics of the Lower Esophageal Sphincter: the Enemy of Good Is Better

T1566 Comparison of the Conventional Manometry and High Resolution Manometry in the Assessment of the Resting Characteristics of the Lower Esophageal Sphincter: the Enemy of Good Is Better

Polyethylene: is the enemy of good, better?

Polyethylene: is the enemy of good, better?

The enemy of good is better!

The enemy of good is better!