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Too Much Medicine

20% Health-Expenditure Wasted

Very High MRI Rates
> €
2 x Caesarean Sections


  • Entering information
  • Diagnosis; Exams; Interventions; Prescriptions; Changes

A hated task but also

a step in research!


Looking for information on specific patient groups

How are patients treated elsewhere and what are the consequences?


Guidelines; Studies; Expert Opinions; Organizational Rules

Under which circumstances should be a specific exam/intervention (not) conducted?


How are patients treated elsewhere and what are the consequences?

We are looking for information on specific patient groups


Comparing Data

  1. Search for similar patients
  2. Summarize results
  3. Submit aggregated result


  • Receiving results from hospitals
  • Final aggregation
  • Visualize results



  • When and where are unusual decisions are made?
  • Who makes them?
  • Are our recommendations not specific enough?
  • Should we recommend other interventions/exams?


  • Patient groups with high treatment variation
  • Deviating institutions and medical staff
    • vs guidelines
    • vs other institutions
  • Identifies causes for geographic variation

Further Analyses

  • Efficacy and Diagnostic information
  • Interventions that lead rarely to better outcomes
  • Exams that rarely lead to interventions

CAVE: causality

Provides Relevant Information

Highlights Problems

Reduces Treatment Variation

Makes Documentation Meaningful