A pair of Pennsylvania physicians say a study that claims medical errors are the third-leading cause of death in the U.S. is based on "shoddy" science and calls for BMJ to retract the paper and issue an apology to the medical community.
The study, published in early May in the BMJ, suggests that more than 250,000 people a year in the United States die due to medical error. And the editors at BMJ are standing by the piece and have no intention of retracting the study, according to Medscape Medical News.
But the research is a “shoddy piece of scientific and statistical work, which cannot stand the close scrutiny of peer physician researchers and professional statisticians," write Shyam Sabat, M.D., an associate professor of neuroradiology at Penn State College of Medicine, and Virginia Hall, M.D., an associate professor of obstetrics and gynecology at PSU, in a blog post published by the Pennsylvania Medical Society.
The physicians said they reviewed the study with Vernon Chinchilli, Ph.D., chair of the department of public health at Penn State College of Medicine. The three determined that the research, which purports itself as a meta-analysis of four studies, used the summary of a downplayed Healthgrades report from 2004--which focused solely on Medicare patients--and three studies with small sample sizes, according to the blog.
The mortality rates in Healthgrades data, the doctors write, was applied unilaterally to all U.S. patients in the BMJ analysis, without correcting for the discrepancy in ages. “How a reputed group such as the BMJ could not see through these simple but outrageous statistical blunders is anyone's guess,” they write.
The Penn State doctors are not the first physicians to question the impact of the study. Vinay Prasad, M.D., assistant professor of medicine at the Center for Ethics in Health Care at Oregon Health and Sciences University, wrote an opinion piece saying the study was “merely reminding us of old data,” FierceHealthcare previously reported.
The publication is standing by the study despite the criticisms, according to Medscape. Navjoyt Ladher, M.D., BMJ analysis and scholarly comment editor and a general practitioner, told Medscape that the journal does not believe there are grounds to retract the paper, but that its editors are monitoring discussions on its validity closely.
E. John Orav, Ph.D., associate professor of medicine in biostatistics at Harvard Medical School and Brigham & Women's Hospital in Boston, told Medscape that a retraction of the article is not necessary, but the authors could have been more clear on the fact that their estimates were based mostly on the Healthgrades data.
"Since Medicare patients account for only one third of all deaths, extrapolating to the other two thirds of deaths is risky,” he said.