{"id":38037,"date":"2016-12-29T17:45:11","date_gmt":"2016-12-29T16:45:11","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/bmj\/?p=38037"},"modified":"2016-12-29T17:45:11","modified_gmt":"2016-12-29T16:45:11","slug":"william-cayley-measurement-or-action","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/bmj\/2016\/12\/29\/william-cayley-measurement-or-action\/","title":{"rendered":"William Cayley: Measurement or action?"},"content":{"rendered":"

\"bill_cayley_2\"<\/a>As our measurements and metrics in medicine proliferate and multiply, it is exceedingly tempting to think that our increased ability to measure correlates directly with an increased ability to care or cure . . . but is this really the case?<\/p>\n

It\u2019s been reasonably well established that just doing a test to \u201crule out\u201d a condition does not actually provide much assurance to patients.\u00a0Testing to reassure offers\u00a0little reassurance.\u00a0<\/a><\/p>\n

However, on the other side of that supposition lies the even more important question of whether testing to diagnose actually provides assurance or motivation. Two recent items\u00a0of medical news caught my attention, and their divergent findings from divergent methods are worth noting.<\/p>\n

Despite the fact that we can now routinely calculate body mass index (BMI)\u00a0using electronic tools during<\/a>\u00a0consultations, a recent study found that<\/a>, at least in the care of children, routine BMI surveillance during office visits and counseling on physical activity have little impact on (the very important problem of) childhood obesity. The authors conclude that there is a need for \u201cthe development of novel approaches for providers to address this problem.\u201d<\/p>\n

Conversely, programs such as the \u201cDaily Mile<\/a>\u201d\u00a0may provide a wide range of health benefits<\/a>, including improved sleeping, better eating, improved fitness, and improved happiness. While I\u2019ve been unable to locate so far any publications of research on the \u201cDaily Mile\u201d program, a similar school based intervention in Oklahoma led to<\/a> improved BMI measurements for boys, and at least stable BMI measurements for girls.<\/p>\n

We need to remember that in medicine the point of measurement is to help answer a question\u2014measurement in and of itself does not do much of anything. So, when it comes to being healthy and pursuing a healthy lifestyle, the most beneficial actions have little or nothing to do with measurement. Rather the most important interventions have to do with action.<\/p>\n

Being healthy is about . . . being healthy. Measurements may tell us things, but actions help us change things. Action may involve programs and group interventions, or it may be a matter of helping our patients find their own internal motivations.<\/p>\n

Either way, the failures of BMI measurement and the apparent successes of the Daily Mile are good reminders of the aphorism: \u201cDon\u2019t just sit there (and measure), do something (go for a run)!”<\/p>\n

William E Cayley Jr<\/strong>\u00a0practices\u00a0at the Augusta Family Medicine Clinic; teaches at the Eau Claire Family Medicine Residency; and is a professor at the University of Wisconsin, Department of Family Medicine.<\/em><\/p>\n

Competing interests:<\/strong>\u00a0\u201cI declare that I have read and understood BMJ policy on declaration of interests and I have no relevant interests to declare beyond my enjoyment of running!\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

As our measurements and metrics in medicine proliferate and multiply, it is exceedingly tempting to think that our increased ability to measure correlates directly with an increased ability to care or cure . . . but is this really the case? It\u2019s been reasonably well established that just doing a test to \u201crule out\u201d a […]<\/p>\n

Read More…<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[1357,14769],"tags":[],"class_list":["post-38037","post","type-post","status-publish","format-standard","hentry","category-us-health-care","category-william-cayley"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/38037","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/comments?post=38037"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/posts\/38037\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/media?parent=38037"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/categories?post=38037"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/bmj\/wp-json\/wp\/v2\/tags?post=38037"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}