Another junk science Patient Safety Pronouncement

Do these people even stop puttin’ up this crap?

NOOOO, because the people who make these pronouncements are feathering their nests as patient safety advocates.

Trust me on this–I do not screw up 5 % of the time and neither do the others.

This is the product of what we call data mining. Looking through charts for what might be mistakes and errors–of course without good methods.

Then there is the business of screening big reams of charts for “incidents” and problems and then working the outcome bias.

Understand when you look for deaths and bad outcomes and then analyze them–smart people with worried looks and clipboards and red pencils will find a screw up. Bound to. That’s why they are doing the reviews. BMJ is part of the cabal of people who push for more central planners and more people with clipboards.

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3 responses to “Another junk science Patient Safety Pronouncement

  1. There is, however, GOOD NEWS: The identity of the world’s Puppetmaster is disclosed on Steven Goddard’s discussion of Climategate and “What should we be striving for now?”

  2. How many of these “misdiagnosis” are caused by patients giving faulty/false information to the attending physician? My daughter, a 2nd year medical student, has done several “shadowing” sessions in the ER, and patient stories there change depending on who the patient is talking to. She’s had people go from non-smokers to pack-a-day habits in 15 minutes….

  3. Stan B.

    Your point is a good one, diagnosis is fraught with unknowns and uncertainties, so a human rate of misses is not easy to predict. Multiple providers doing lots of stuff and what’s the denominator for negligence or mistakes or misjudgments?

    The problem with these patient safety claims is they are driven by outcome bias. They don’t count every chart or encounter, they do an analysis of Sentinel events, like deaths, and then look for mistakes or oversights or omissions. it pushes the results to higher rates of alleged negligence.

    read my papers put up on junkscience to get a feel for it.

    and pay attention to the statement by troyen Brennan, an honest man, lead researchers in the Harvard patient safety research program.

    Patient safety issues

    In the early 90s as a part of the project to denigrate American Healthcare, patient safety was added to the mix as another reason why government healthcare was the only answer, at the same time costs continued to increase and regulations reduced the impact of free markets, insurance companies were mandated to provide more benefits, people continued to expect little out of pocket expenses but utilized the system heavily.

    I analyzed the results of the notorious Harvard study of New York Hospitals publish in the New England Journal of Medicine and found the junk science methodology. In fact almost a decade later Troyen Brennan MD JD, lead researcher in the Harvard group, admitted their methods were unreliable and their judgements as to what was malpractice or negligence or preventable were not necessarily reliable. He said in an essay in the New England Journal of Medicine

    Dr. Brennan said:
    Troyen Brennan M.D., J.D. — a lead Harvard researcher on the two studies that were the backbone of the IOM report and the source of the negligence death numbers that scared so many — asserted in an essay in NEJM that the research of the Harvard group was weak and was being misused by the IOM. Brennan wrote:

    –”I have cautioned against drawing conclusions about the numbers of deaths in these studies.”

    –”The ability of identifying errors is methodologically suspect.”

    –”In both studies (New York and Utah/Colorado) we agreed among ourselves about whether events should be classified as preventable…these decisions do not necessarily reflect the views of the average physician, and certainly don’t mean that all preventable adverse events were blunders.”

    Brennan TA. The Institute of Medicine report on medical errors — could it do harm? NEJM 2000;342:1123-1125.

    Here are my two essays on why the methods and finding and scare tactics of the patient safety movement were junk science:

    I showed my proof by comparing my data on studies of more than 300,000 hospital admissions analyzed by the Texas Medical Foundation, compared to the 30,000 admissions study in New York.

    I concluded that the patient safety crisis was manufactured with unreliable methods and exaggerated claims. The misleading methods include using a small study, big projection game that starts with outcome bias and confirmation bias, then uses the small study numbers to project to a large population, voila big crisis.

    This first paper I wrote in response to the panicmongering generated by the Institute of Medicine (Subdivision of the National Academy of Sciences) release of “To Err is Human” that claimed doctors and nurses were killing up to 98,000 people in hospitals in America every year.

    Dunn JD. Patient safety in America: comparison and analysis of national and Texas patient safety research. 2000;96:66-74. Available
    at: 23751.pdf.

    The second essay was in response to another effort to gin up a safety crisis in the New England Journal of Medicine.
    Dunn JD. Patient safety research: creating crisis. Jan 10, 2005.

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