Two researchers have challenged a recent British Medical Journal analysis that said medical error is the third leading cause of death in the US.  In a searing response to the analysis, also published in the BMJ, researchers wrote that the results came from a flawed, informal methodology and misconstrued how many people died annually from medical error.  “As concerned citizens, we would rather not have medical care characterized as more dangerous than firearms or motor vehicles,” wrote Kaveh G Shojania, a scientist at Sunnybrook Research Institute, and Mary Dixon-Woods, a Rand professor of health services researcher.  Their response said that the analysis’s methodology was “precarious” because it extrapolated on death rate evidence from differing studies and compared that information with the top-ranking causes of US deaths.  They also said that they “and many clinicians and researchers” find the numbers hard to believe because only 700,000 deaths occur in hospitals each year, which would mean the analysis shows one-third of deaths in hospital were caused by medical error.  Martin Makary and Michael Daniel, the Johns Hopkins University’s school of medicine researchers who authored the medical error analysis, could not be reached for comment.  But in the analysis, they said that they calculated the medical error deaths because the international classification of disease (ICD) for coding deaths in the US – which is also used in 117 countries – does not include a label for medical error.  In the response to the analysis, the researchers also did their own calculation on medical error deaths by looking at previous studies on the topic. By their calculations, the studies show that 25,200 deaths annually are potentially avoidable – that is 10% of the initial study’s estimate.  The response authors said they were concerned that the headline-grabbing medical error study lost the nuance of patient safety by tying the practice to deaths.  “Just as most deaths do not involve medical error, most medical errors do not produce death – but they can still produce substantial morbidity, costs, suffering and distress,” they said. “Drawing attention only to death as the focus of patient safety efforts risks drawing resources away from many settings of care – including almost all non-hospital environments – where death is not the most relevant outcome.”  The response authors said they could agree with the analysis authors on one point: “They say that ‘sound scientific methods, beginning with an assessment of the problem, are critical to approaching any health threat to patients’,” the researchers said. “Sadly, their paper does not exemplify such sound science.”
Two researchers challenged ‘characterization of medical care as more dangerous’ than guns or cars and provided numbers that were 10% of original findings