Central PA Medicine - February 2017 - 25

daup h i n c m s .o
.o rg

modernhealthcare.com, Medscape.com, fiercehealthcare.com, and clinicaladvisor.com to
name a few.
THE OUTRAGE
Responses by physicians and other medical
practitioners to the paper and the change.
org petition were mostly scathingly critical
of the paper:

also noted the BMJ has a "rapid response section"
to allow readers to challenge and debate articles.
"We invite Dr. Sabat and Dr. Hall to make
their points in a rapid response to the analysis
article, thus giving the authors and other
readers an opportunity to read and reply to
their comments. We will continue to watch
closely as the discussion develops."

"This paper was
an alarmist
misuse of
medical
statistics."

"I would like to add my voice to the THE BMJ FINALLY RELENTS
call for the retraction of this article. The (THOUGH DOES NOT RETRACT)
statistics have been shown by multiple
A month after the study was published, a
On one point, we agree with Marky and
respondents to be bunkum, no need to joint comment appeared on BMJ's website: Daniel: they say that 'sound scientific methods,
repeat. Why is this sensationalist nonsense "We appreciate the urge to draw attention to beginning with an assessment of the problem,
still here? Why was it published in the this area." The statement was written by Kaveh are critical to approaching any health threat to
first place in fact? Be brave BMJ, admit Shojania, a physician and researcher who is the patients.' Sadly, their paper does not exemplify
the mistake."
editor-in-chief of the journal BMJ Quality & such sound science.''
Safety, and Mary Dixon-Woods, the RAND
"I have practiced medicine for 33 years in professor of health services research at the SAFE, RESPONSIBLE MEDICINE
the U.S. and know of only a few deaths where University of Cambridge.
Safety and quality are very important aspects
medical error may have been a factor. During
of medicine and physicians must strive for
those 33 years, there have been approximately
The statement continued, "But it is critical continual improvement. In fact, we should
80 million deaths in the US, mostly under that the claims made to secure attention are strive for six sigma (99.997%) or higher levels
medical care. So intuitively and with some well-founded. We worry that this estimate is of accuracy in medical practice, as has been
authority, I know that this absurd article is not," they added. "First, the estimate fails the achieved by several other manufacturing and
junk dressed up as science."
plausibility test. We - and many clinicians service industries. Simultaneously, the flaws
and researchers - find it very hard to believe should be studied and published by rigorous
"This paper was an alarmist misuse of that one in 10 of all US deaths, or a third and tested peer-reviewed methods - not grossly
medical statistics."
of inpatient deaths (the 251,454 estimated flawed methods as employed in this paper.
by Makary and Daniel) result from 'medical
"I'm signing because this statistical abuse error'. Second, the authors of the article do LESSONS LEARNED
has spread and is resulting in misallocation not provide any sort of formal methodology.
Every now and then, whether sincerely
of resources."
Their estimate seems to rely on extrapolating or guided by a subtle desire to get more of
preventable death rates from those reported the allotted government 'safety & quality'
"Is outrageous how ignorant statisticians in other studies. They then place the estimate grant-pie, there will be people, including
want to make a penny by throwing dirt at the derived from these heterogeneous studies in a our very own physician researchers, who will
US physicians. Go get a job and be honorable." "ranking" of causes of death in the U.S. to make try to put arguments and shoddy papers to
their argument that it is the third leading cause. prove what an awful job other U.S. physiBMJ GETS NERVOUS, BUT PUTS
These two steps are both precarious."
cians are doing. Practicing physicians and
UP A BRAVE FACE
medical societies should be vigilant and put
Dr. Navjoyt Ladher, BMJ editor, said in an
They further wrote, "As people who care up scientific rebuttals and fierce resistance
emailed statement to Medscape, "The Analysis deeply about patient safety, we are troubled by to such acts; otherwise those days won't be
section of the BMJ is a forum for scholarly figures that produce lurid headlines but distract far where instead of being listed under the
comment articles. In line with our usual process, from areas where harm may be most amenable 'most respected' professions (Forbes 2016),
the article was reviewed internally by editors to interventions. As researchers, we fear for doctors would find themselves sharing
and a statistician, and externally peer-reviewed efforts to engage with clinicians when they are the 'most despised' professions list in the
by several experts.
confronted by headline-grabbing numbers that U.S. along with politicians, Wall Street
fly in the face of their clinical experience. And, bankers, lawyers and used car salesmen
"We do not believe there are any grounds to finally, as concerned citizens, we would rather (www.toptens.com).
retract the paper, and are not considering this not have medical care characterized as more
course of action. We will continue to watch dangerous than firearms or motor vehicles."
closely as the discussion develops," he said. He
Central PA Medicine February 2017 25

http://www.dauphincms.org http://www.modernhealthcare.com http://www.Medscape.com http://www.healthcare.com http://www.clinicaladvisor.com http://www.toptens.com

Table of Contents for the Digital Edition of Central PA Medicine - February 2017