Stick it in

We recently drew attention to the UKAS customer satisfaction survey.  What a fantastic organization!…think those who bothered to return the questionnaires.  Do their own customers rate them so highly?  Did they rate them lower before they were accredited?

Doug Powell shares a low opinion of opinion polls:

“FSA’s idea of risk communication is to commission a meaningless surveypeople lie, especially about food and drink – which found that despite 71% of people stating that they are concerned about food poisoning, over a third (36%) of Brits would eat a burger that isn’t fully cooked through. More than one in 10 said that they actually prefer burgers cooked this way.  When cooking them at home 81% of those admit to undercooking them. So we at the FSA are encouraging all those who are getting their barbecues out this weekend to ensure they cook their burgers all the way through – until steaming hot throughout, there’s no pink meat in the middle and the juices run clear.

“Those scientifically meaningless terms – steaming hot, no pink – have featured prominently in FSA food safety talk for years, with steaming hot replacing piping hot.

“Lead FSA policy thingy said something that is not worth repeating because it ignores the risks associated with needle-tenderized steaks.”

Stick it in

 

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A Decade of Reversal: An Analysis of 146 Contradicted Medical Practices

Prasad et al. have published an analysis of 146 medical practices that had to change when they were shown to have no benefits.  A large proportion of treatments remain of unknown effectiveness or may be harmful.

gr2

 

For this reason the authors favour a high barrier of validation before new practices enter widespread use.

“Recently, a project of BMJ, entitled Clinical Evidence,81 completed a review of 3000 medical practices. The project found that slightly more than a third of medical practices are effective or likely to be effective; 15% are harmful, unlikely to be beneficial, or a tradeoff between benefits and harms; and 50% are of unknown effectiveness. Our investigation complements these data and suggests that a high percentage of all practices may ultimately be found to have no net benefits. 

“To our knowledge, this is the largest and most comprehensive study of medical reversal. Previously, we have considered the causes and consequences of reversal.4-6,82 When medical practices are instituted in error, most often on the basis of premature, inadequate, biased, and conflicted evidence,4 the costs to society and the medical system are immense.5 As such, we favor policies that minimize reversal. Nearly all such measures involve raising the bar for the approval of new therapies6,83,84 and asking for evidence before the widespread adoption of novel techniques. In all but the rarest cases,82 large, robust, pragmatic randomized trials measuring hard end points (with sham controls for studies of subjective end points) should be required before approval or acceptance. Our position is in contrast to efforts to lower standards for device and drug approval,85 which further erodes the value of the regulatory process.” (emphasis added.)

The paper is further indirect endorsement of this blog’s argument that laboratory accreditation is unproven and should never have been accepted until third-parties could offer convincing evidence of its value.

Without genuinely critical research, who is going to know that accreditation is a sham?

Suitably powered proof should have come before acceptance.  Professional leaders should be ashamed of their naïveté in doing the reverse.

Image result for professional naivete

They were so convincing…I never thought something so expensive could be of such little value…

 

 

 

 

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The Dark Side of Tight Financial Control: Causes and Remedies of Dysfunctional Employee Behaviors

Goebel, S. & E. Weißenberger, B. Schmalenbach Bus Rev (2016) 17: 69. doi:10.1007/s41464-016-0005-8

Abstract

Following recent corporate accounting scandals and governance failures, there has been a renewed interest in dysfunctional employee behaviors as potential drawbacks of financial goal-setting. Our study therefore assesses the impact of tight financial results controls as a cause for common behavioral displacements like information manipulation or gaming behavior in combination with countervailing effects of informal controls and management accountants’ business orientation as potential remedies. Based on a cross-sectional survey among 295 large- and medium-sized companies, our results show that even though a strong emphasis on financial results controls is associated with dysfunctional behaviors, higher levels of informal means of control and a more intense business orientation of management accountants are associated with a decrease of behavioral displacements. Our paper contributes to literature in a twofold way. First, it adds to the extant management accounting and control literature by providing comprehensive insights into the interplay between tight financial controls, informal controls, and management accountants’ role-taking behaviors. Second, by using a large-scale survey design, our results reflect a broad array of organizations and control situations.

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The Freeman – Mad Science

The Summer issue of The Freeman presents a collection of articles on mad science.

cover image The Freeman: Summer 2016It describes the dangers of giving control to an expert elite and illustrates it with example ideologies such as Darwinian eugenics that had to wait for the Nazis to discredit it, believing misfortune arises from witchcraft, climate change, and failing to recognize the contrary consequences of laws that may have been good-intentioned.

In Policy Kills Science, Jeffrey Tucker relates the passing of eugenics dogmas – see how the mighty constraints of thought pass away:

But back then, eugenic ideology was conventional scientific wisdom, and hardly ever questioned except by a handful of old-fashioned advocates of laissez-faire. The eugenicists’ books sold in the millions, and their concerns became primary in the public mind. Dissenting scientists — and there were some — were excluded by the profession and dismissed as cranks attached to a bygone era.

“Eugenic views had a monstrous influence over government policy, and they ended free association in labor, marriage, and migration.”

Surprisingly, the magazine fails to deal directly with ISO accreditation.  Despite the waste it creates, perhaps accreditation too will one day be forgotten.

“There are, however, lessons to be learned. When you hear of some impending crisis that can only be solved by scientists working with public officials to force people into a new pattern that is contrary to their free will, there is reason to raise an eyebrow. Science is a process of discovery, not an end state, and its consensus of the moment should not be enshrined in the law and imposed at gunpoint.

“We’ve been there and done that, and the world is rightly repulsed by the results.”

In How Networks Topple Scientific Dogmas, Max Borders suggests this could happen by networking of critical amateurs.

“The best thing that can happen to science is that it opens itself up to everyone, even people who are not credentialed experts. Then, let the checkers start to talk to each other. Leaders, influencers, and force-multipliers will emerge. You might think of them as communications hubs or bigger nodes in a network. Some will be cranks and hacks. But the best will emerge, and the cranks will be worked out of the system in time.

“The network might include a million amateurs willing to give a pair of eyes or a different perspective. Most in this army of experimenters get results and share their experiences with others in the network. What follows is a wisdom-of-crowds phenomenon. Millions of people not only share results but challenge the orthodoxy.”

Scientists are not always the best people to understand science.  Sometimes those outside the trees see the forest better.

Roll on the network of “accreditation deniers”!

 

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Straw poll

If you knew ten people with experience of ISO accreditation you could conduct a straw poll now.

See if nine out of ten really think what was reported to UKAS in their customer satisfaction survey.  Or do they fail to respond to UKAS’s solicitations and use foul language to your own questions?

What would happen if the next ISO revision compelled the accredited to respond to UKAS customer satisfaction surveys to retain their accreditation?

Nah, silly idea.  It’ll never happen.

UKAS Customer Satisfaction Survey – Q1 2016-17
◾86% were satisfied or very satisfied with UKAS’ overall service over the last year.
◾99% were satisfied or very satisfied that the UKAS assessment team had the right skills and knowledge.
◾94% were satisfied or very satisfied that the assessment team had the right attitude.
◾90% were satisfied or very satisfied that UKAS generally responded to your needs in a timely manner.

Unsurprisingly, when you click through to the full report, there is no mention of the total number invited to respond or the number that did.  Only percentages.  And certainly no uncertainty of measurement indicators like they impose so strongly on laboratories.

Alright for ISO 9001 but proof that accrediting science is not done scientifically?

The simple graphs show a less impressive picture than the percentages in the text, but it’s still much better than you might guess from asking victims face to face.

It seems like a good show overall.  “Delivering confidence”, as they say themselves.

So ask ten accreditation victims yourself.  They might change your world.

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>90% say accreditation delivers benefits…but…

Authors employed by bodies including the US Public Health Accreditation Board (PHAB) have written that >90% of public health departments the PHAB accredits report benefits that might have been expected.

This sounds a lot like ISO accreditation although the details of the accreditation regime are not given in the paper.  Perhaps it’s better.  At least it is still voluntary.

Kronstadt J, Meit M, Siegfried A, Nicolaus T, Bender K, Corso L. Evaluating the Impact of National Public Health Department Accreditation ― United States, 2016. MMWR Morb Mortal Wkly Rep 2016;65:803–806. DOI: http://dx.doi.org/10.15585/mmwr.mm6531a3

Summary

What is already known about this topic?

In 2011, the Public Health Accreditation Board launched the national, voluntary public health accreditation program as a strategy to advance the quality and performance of governmental public health departments. As of May 2016, 134 state and local health departments have been accredited. In addition, Florida, in which employees of all 67 local health departments are employees of the state, achieved accreditation for the entire integrated local public health department system in the state. Collectively, nearly 167 million persons, approximately half the U.S. population, are covered by an accredited health department.

What is added by this report?

A survey of health departments that had been accredited for one year indicates that >90% report experiencing benefits such as stimulation of quality improvement and performance improvement opportunities; increased accountability and transparency; and improved management processes.

The authors acknowledge at least three serious limitations:

The findings in this report are subject to at least three limitations. First, all survey data are self-reported and have not been verified independently. Social desirability bias could result in respondents overreporting their quality improvement activities. Second, survey respondents are among the early adopters of accreditation. Although the health departments included in this study were diverse in size, geographic location, and structure, they might not be representative of all health departments. Finally, because accreditation is a voluntary program, selection bias might apply. For example, health departments are required to provide examples of quality improvement activities to demonstrate conformity with the PHAB standards. Therefore, health departments that were already active in this area might be more likely to apply, particularly in the first few years of the accreditation program. As a growing number of health departments are accredited, future studies can use other quantitative techniques to study the effects of accreditation. 

Without taking these more seriously in their analysis it’s just a user satisfaction survey like the ones the BSI and UKAS do to congratulate themselves and fool the buyers.

UKAS Customer Satisfaction Survey – Q1 2016-17

  • 86% were satisfied or very satisfied with UKAS’ overall service over the last year.
  • 99% were satisfied or very satisfied that the UKAS assessment team had the right skills and knowledge.
  • 94% were satisfied or very satisfied that the assessment team had the right attitude.
  • 90% were satisfied or very satisfied that UKAS generally responded to your needs in a timely manner.

You can test this yourself using a ISO 9001 customer satisfaction survey template.

iso 9001 survey

PR, not science

At best this MMWR report is uncontrolled research like most of the journal papers reporting benefits from ISO accreditation.  Attempts at controls are rare and controlled results are the opposite of customer satisfaction surveys.

Without controlling for the biases identified, of what value are the results?

How would it feel to have done so much work, to have paid so much money if accreditation failed to deliver its promise?  Maybe that’s why the accreditation victims rate it so highly.

Next time, try asking customers questions like,

What specific benefits have you noticed since accreditation? 

Answers like “better quality” or “complies with regulations” don’t count.

How much would you be willing to pay for this improvement?

See if the people that matter obtain real benefits or whether accreditation only helps the inspectors.

 

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“no treatment regimen was identified as having an improved clinical outcome”

Accreditation relies on auditing for total compliance with SOPs.  Inspection of this assures quality.  Even when it doesn’t.

Drs Williams and Brindle reported another type of audit and showed wide variation for the treatment of an infective condition.

Journal of Infection Volume 73, Issue 3, September 2016, Pages 291–293

Audit of guidelines for antimicrobial management of cellulitis across English NHS hospitals reveals wide variation

“In summary, our audit has highlighted significant variability in the management of cellulitis across the 23 acute NHS Trusts examined. This heterogeneity was identified across the choices of antibiotics recommended, the modes of administration, and the duration of therapy. It has also highlighted the variability of recommendations by individual clinicians based on the perceived severity of the infection. Although the numbers of guidelines examined is relatively small, and geographically restricted, it is likely that such variability is a feature across most acute Trusts in the UK.

“The Cochrane review has identified 43 studies, omprising 5927 patients, with outcome data on patients treated for cellulitis using a bemusing variety of treatment regimens. Overall, no treatment regimen was identified as having an improved clinical outcome when compared with another antibiotic, and no recommendation could be made for any single antimicrobial. As all antimicrobials examined appear to be equally effective it is recommended that a narrow spectrum anti-staphylococcal penicillin (e.g. flucloxacillin) or a macrolide or lincosamide (for those unable to tolerate a beta-lactam) should be used for the treatment of cellulitis.”

We might expect that a similar range of acceptable variation might exist in many other situations where UKAS demands conformity to a single procedure they can inspect.  Just as no treatment regimen was found to have an improved treatment outcome, in many circumstances no single procedure enforced to the purposes of compliance audit will be able to justify itself either.

Uniformity isn’t the only good way.

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UKAS collaborates with sharia to fund Islamic expansion

UKAS accrediting halal is endorsing dawa

International halal accreditation is not agreed by a single body but by hundreds and is highly non-standardised, like Islam itself.  We previously drew attention to this here. UKAS is now pleased to help bring the world into submission to Allah while receiving its share of the fees.

Will it make the food uncompetitively expensive and with less money going to funding Islamic murder and injustice both by jihad and foisting halal food on naïve populations?

Or will accreditation be done on the poorly and on the cheap, as UKAS can do when it suits commercial interests?

Most halal food is produced by developed nations since the demands of Islam prevents Islamic countries from developing internally and forces them to export their best academics and buy in Western knowledge, technology and capacity.

Islam fights the West on which it depends

Who would have thought UKAS would conspire to accredit the funding for events like these?

On June 8, Bangladesh's Christian Association organize a protest in front of the national press club, against the killing of Sunil Gomes and others in Dhaka. Unidentified attackers murdered the 65-year-old Sunil Gomes in the village of Bonpara, home to one of the oldest Christian communities in Muslim-majority Bangladesh. “Sunil Gomes was hacked to death at his grocery store just near a church at Bonpara village,” said Shafiqul Islam, deputy police chief of Natore district.

On June 8, Bangladesh’s Christian Association organize a protest in front of the national press club, against the killing of Sunil Gomes and others in Dhaka. Unidentified attackers murdered the 65-year-old Sunil Gomes in the village of Bonpara, home to one of the oldest Christian communities in Muslim-majority Bangladesh. “Sunil Gomes was hacked to death at his grocery store just near a church at Bonpara village,” said Shafiqul Islam, deputy police chief of Natore district.

But it isn’t all about killing:

Welsh schoolgirl was ‘kept prisoner in a cage, starved and abused because of her un-Islamic lifestyle’

Fireman Sam producer apologises after showing character treading on page from the Koran

Learn about the coercion and mind control that is going on here:

The process of Islamisation

Both traditional Muslims and Islamists[29] promote the halal/haram system as a way of protecting the Muslim community from the supposedly polluting influences of secular, non-Muslim society.[30] However, many Muslim scholars assert that the halal and haram rules are not for Muslims only, but for all human beings.[31] They claim that those who engage in haram activities are under Allah’s curse and deserve punishment; that those who create their own laws while ignoring Allah’s laws on the permitted and the prohibited are guilty of the most serious sin of shirk.[32] Thus, they believe, halal and haram are part of Islamic da‘wa: it is the duty of Muslims to spread the rules to non-Muslims, not only to implement Allah’s will but also for the good of non-Muslims.[33]

Coercion is essential when the arguments are weak.

How verifiable and traceable is halal/dawa/sharia that UKAS can enforce it?

What is the uncertainty of measurement for such beliefs?  Precisely how far from pigs and pests does the food have to be?  Do the pigs need to be GPS tagged to be certain?

How testable a hypothesis is sharia?

Or do UKAS really only care about extending their monopoly into death fetishism?

Victims know accreditation is all about enforcement,  inspection and the worship of GDP. Science is just a pretext.

Your new UKAS assessor?

UKAS’s account of their complicity in dawa follows:

International Halal Accreditation Forum is established

UKAS was pleased to be invited to become a foundation member of the International Halal Accreditation Forum (IHAF) in May 2016 after the IHAF was established by the United Arab Emirates’ Government. The primary objective of establishing the IHAF is to harmonise conformity assessment practices in the Halal field, and establish Multilateral Recognition Agreements between member bodies that will facilitate Halal trade globally. UKAS currently has some active enquiries in the area of Halal certification and is keen to ensure that any new areas of work are consistent with the work of other accreditation bodies, and in line with existing ILAC and IAF arrangements. It is expected that the work of the IHAF will develop over the coming months.

Other foundation members include:

  • Dubai Accreditation Department (DAC, UAE)

  • Emirates National Accreditation System

  • General Coordination for Accreditation (CGCRE, Brazil)

  • American Association for Laboratory Accreditation (A2LA, USA)

  • Pakistan National Accreditation Council (PNAC, Pakistan)

  • Entidad Nacional de Acreditacion (ENAC, Spain)

  • Gulf Centre for Accreditation (GAC)

  • Saudi Accreditation Committee (SAC, Saudi Arabia)

  • The Joint Accreditation System of Australia and New Zealand (JAS-ANZ, Aus/NZ) 

Read this paper and see how messy and non-standardised halal is for the food you eat and the murder you fund:

Marin Neio Demirci, Jan Mei Soon, Carol A. Wallace.  Positioning food safety in Halal assurance. PII: S0956-7135(16)30305-X. DOI: 10.1016/j.foodcont.2016.05.059. Reference: JFCO 5076. To appear in: Food Control.

Positioning Food Safety in Halal Assurance

Marin Neio Demirci, Jan Mei Soon and Carol A. Wallace.  International Institute of Nutritional Sciences and Applied Food Safety Studies, School of Sport and Wellbeing, University of Central Lancashire, Preston, Lancashire PR1 2HE, United Kingdom

ABSTRACT

Muslims follow the religion of Islam and the food they eat should be Halal, meaning lawful or permissible. Muslims are allowed to eat halal and wholesome food that has been provided for them. However, some of the main prohibitions are swine flesh, blood, carrion, animals not slaughtered according to Islamic laws and alcoholic drinks. At present Halal assurance is in a complicated state, with various Halal standards differing from each other without gaining mutual acceptance. The world is starting to understand the need for an influential globally accepted standard that would open doors to global markets and gain consumer confidence. This paper discusses issues mainly related to food safety in Halal assurance. The aim was to discover and describe the approach to food safety requirements in Halal food provision and how this is incorporated in the Halal assurance systems. The position of food safety regulation within Halal requirements or Halal standards’ requirements for food safety is still unclear. This review also considers whether current Halal standards include criteria in common with internationally accepted food hygiene standards and emphasizes the potential of using the HACCP system for Halal assurance.

Should an inspection monopoly guaranteed by the British government be used to enforce submission to sharia on the population of the world?

But is it really halal if Islamic law itself, an older and more enduring mind-control cult, is subjected to the newer, higher standard of ISO accreditation which lacks much will to kill?

Aren’t ISOs haram because they were conceived without submission to sharia and management ISOs are a secular alternative to Islamic oppression?

How then can haram ISO accreditation validate sharia law?

Since halal slaughtermen must be Muslims, will UKAS inspect their madrassa training records to ensure they are up-to-date Muslims?  Will the madrassa training records be sufficient?  How about the method witnessing records for their daily practice of Islam?  If these are not in order, the meat won’t be halal.  Or maybe UKAS will just use more relaxed standards than they impose on labs.

Will the ISO meet its doom in sharia once it gets conformed itself, as it will have to be?

How surprising is it that two bullying cults, one supposedly religious, one supposedly secular, should collaborate in this way?  Not very surprising at all – what they have in common is the justification of defective dichotomous thinking, unprovable dogmas, protection rackets (accreditation/jizya extortion) and bullying.

UKAS and Islam will share the profits of accreditation to spread the harm of both by funding dawa.

To understand more download the book, Dawa by Patrick Sookhdeo  or peruse and purchase it here:

A global survey of Islamist strategies and tactics for missionary outreach (dawa) in the 21st century, this easy-to-read book analyses the process of Islamisation at an individual and societal level. Looking at politics, law, education and other spheres, in a wide range of countries, it reveals the underlying patterns, structures and organisation. It also examines the theological roots of dawa that inspire Islamists today. Suitable for any interested reader, but well referenced for students.

A global survey of Islamist strategies and tactics for missionary outreach (dawa) in the 21st century, this easy-to-read book analyses the process of Islamisation at an individual and societal level. Looking at politics, law, education and other spheres, in a wide range of countries, it reveals the underlying patterns, structures and organisation. It also examines the theological roots of dawa that inspire Islamists today. Suitable for any interested reader, but well referenced for students.

Rejecting a relaxed standardisation:

Leads to a sterner variety:

Prof-Muhari-killed-by-Islamic-militants

Wouldn’t eat at Nandos

Not many investigate the reasons for what follows a changing of the gods.

 

 

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Brexit – “very little will change”

UKAS Brexit statement

UKAS accreditation of certification, inspection, testing and measurement services plays a key role in maintaining the UK’s world-leading quality infrastructure. Certificates issued by UKAS and UKAS accredited organisations are recognised internationally through UKAS’ membership of the European co-operation of Accreditation (EA), the International Laboratory Accreditation Co-operation (ILAC) and the International Accreditation Forum (IAF). Following the recent referendum on EU membership, the situation currently remains the same and there is no change to UKAS’ status, nor the status of certificates issued by UKAS accredited organisations.

The situation following exit from the EU will depend on the terms of the exit package negotiated but UKAS expects the recognition of certificates to continue through continued UKAS membership of EA and/or ILAC and IAF.

UKAS will continue to monitor the situation closely by working with both the Department for Business, Energy and Industrial Strategy and our European and international counterparts, but our current expectation is that very little will change, from an accreditation point of view, as a result of the referendum.

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Is the NHS sustainable? Perhaps, if money ceases to be wasted.

Clinical trial design is still far from perfect.

CMI highlight: What’s wrong with trial design and how can we improve it?

Marc Bonten from the University Medical Center Utrecht published a comment outlining why he considers traditional randomized controlled trials (RCT) designs as suboptimal and inefficient to answer infectious disease questions. He concludes by proposing strategies to overcome the issues. To increase generalizability he suggests embedding trials in daily care practice and to immediately enrol all eligible patients. He also stresses the importance of using fully anonymized outcome data and establishing sufficient power for pre-defined subgroup analyses. Finally Professor Bonten suggests repeating analyses throughout the study and allowing for adaptive randomization to avoid statistically significant beneficial effects being hidden in a subgroup. › Read more

And we need researchers to bother asking about why ISO quality accreditation is permitted to continue with almost no trials of its worth.  We need ongoing audits of audits and analysis of EQA data to investigate whether accreditation has any value.

It needs to have value in excess of it massive cost.

If it has zero value maybe it shouldn’t be done.

26 Jun 2016 Dr Robert Morley @drbobmorley

Why would you trust an inspector more than a highly-qualified professional?

Maybe just to break the NHS.  Its sustainability is being examined in parliament.

Government officials give evidence on NHS sustainability

12 July 2016

On Tuesday 12 July, the newly appointed Committee on the Long-term Sustainability of the NHS hears from senior officials from the Department of Health and the Department for Communities and Local Government at its first evidence session…

Possible questions

The session covers a broad range of topics with questions including:

  • what long-term thinking is taking place within Government about the sustainability of the NHS over the next 15-20 years?
  • to what extent is the current healthcare funding envelope realistic?  
  • what analysis has the Government done on different pricing structures and financial systems to help determine where money might be best spent?
  • what is the Government’s workforce planning for the next 15-20 years?
  • what are the practical changes required to provide the population with an integrated National Health and Care Service?
  • to what extent is digitisation of data and services happening?
  • what long-term strategy do you have for public health and prevention?

Other poor decisions about reducing NHS costs have been responded to by the ACB.

ACB Response to NHS Improvement Letter

11/07/2016 10:34:32

NHSI has written to all Trusts outlining the financial position and highlighting three areas where action is required:

  • Elimination of pay cost growth
  • Back office and pathology consolidation
  • Unsustainable service consolidation.

The ACB has written a response detailing that pathology is not a back office function and that consolidation does not always lead to financial savings.

See the ACB response and the NHSI letter below:
pdf Image ACB response to NHSI letter July 2016
pdf Image 2016-06-28 Letter re 2016-17 Financial Positions to Chairs & CEOs final

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