BMJ study on medical errors flawed, not 'innovative,' doctor writes

A recent study published in The BMJ, which found that medical errors are the third leading cause of death in the U.S., has flaws that prevent the findings from being truly innovative, according to a commentary published by STAT.

The researchers, who concluded that more than 250,000 Americans die each year due to medical errors, are "merely reminding us of old data," writes Vinay Prasad, M.D., assistant professor of medicine at the Center for Ethics in Health Care at Oregon Health and Sciences University, in the opinion piece. To provide a more accurate picture of how many deaths can be attributed to medical errors, the study team should have "made tough decisions about what deaths were truly errors" in the data, he writes.

Prasad argues that the study team's definition of "medical error" was too broad because they considered it as any action that does not achieve its intended outcome or a planned action that, for any reason, is not performed and leads to patient harm. Prasad says a better working definition would be: something a provider did or did not do that led to patient harm and the action should have been done differently given what was known, or not know, about the patient's condition at that time.

"When it comes to suspected errors, those who think they can always pinpoint which actions led to potentially preventable harm are either kidding themselves or are incredibly arrogant," Prasad writes. "One of the most difficult things about medicine is that much of the time we don't know for sure if an outcome would have been different had we acted another way."

To learn more:
- read the commentary

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