BMJ  2007;335 (24 November), doi:10.1136/bmj.39406.590822.47

Editor's Choice

Careful what you measure

The first 150 words of the full text of this article appear below.

Back in the 1920s, workers at the Hawthorne electrical factory in Cicero, Illinois, were given better lighting and their productivity improved. Further investigation found that the same improvement could be achieved by almost any change to their environment. One version of what has since become known as the Hawthorne effect says that the very act of measuring something changes what people do. It's one reason why we must choose wisely what we measure in health care.

This week, in the fourth article in our series on performance measurement, Iona Heath and colleagues add a plea for more clinically meaningful measures (doi: 10.1136/bmj.39377.387373.AD). Focusing on process rather than clinical outcomes reduces clinical complexity to a series of boxes for ticking and encourages overtreatment and medicalisation, they say. Doctors are undermined and patients' individual needs are ignored. "Authentic dialogue between doctor and patient is disrupted and many doctors feel fundamentally compromised." . . . [Full text of this article]

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