The data tells a somewhat depressing story. Yes, the people who maintained certification did a bit better on things like ordering mammograms and whatnot, but overall it seems like patients are falling through the cracks– fewer than half of the diabetic patients in either group got all 3 recommended screenings. This data suggests we can be doing a lot better, but it doesn’t look like MOC is the way to greatness if you catch my drift.

But if you want to hang your hat on those small observed differences, the “E-Value” would like a word with you. An E-value is the size of association an unmeasured confounder would have to have with the exposure (in this case maintenance of certification) and an outcome (in this case a given quality metric) to get rid of the statistical significance. If your E-value is really high, as a researcher you can say – sure – this wasn’t a randomized trial, but for my observation to not hold true there would have to be a crazy powerful, unmeasured third factor coloring the data.