Simple questions: Is the 12% full recovery rate of tPA a medical error? What should ER doctors have done about that knowledge way back in 1996 when it was approved for use?
Is every 30 day stroke death a medical error? Because your doctors and stroke hospitals never initiated any research to stop the 5 causes of the neuronal cascade of death in the first week?
Are medical errors really the third most common cause of death in the U.S.? (2019 edition)
There is a myth promulgated by both quacks and academics who should know
better that medical errors are the third leading cause of death in the
United States. You’ll see figures of 250,000 or even 400,000 deaths each
year due to medical errors, which would indeed be the third leading cause of death after heart disease (635,000/year) and cancer (598,000/year). When last I discussed this issue three years ago,
specifically a rather poor study out of The Johns Hopkins that
estimated that 250,000 to 400,000 deaths per year are due to medical
errors, I pointed out how these figures are vastly inflated and don’t
even make any sense on the surface. For one thing, there are only 2.7
million total deaths per year in the US, which would mean that these
estimates, if accurate, would translate into 9% to 15% of all deaths
being due to medical errors. Those numbers just don’t make sense. It’s
even worse than that, though. This particular study looked at
hospital-based deaths, of which there are around 715,000 per year,
which would imply that these estimates, if accurate, would mean that
medical errors cause between 35% and 56% of all in-hospital deaths,
numbers that are highly implausible, something that would be obvious if
anyone ever bothered to look at the appropriate denominators.
Unfortunately, in the three years since its publication, the Makary
study has taken on a life of its own, and it’s basically become commonly
accepted knowledge that medical errors are the third leading cause of
death, even though this estimate is based on highly flawed studies and
these numbers are five- to ten-fold greater than the number of people
who die in auto collisions every year.
Yes, Arthur Allen, a writer I’ve admired since his book Vaccine, casually included that factoid in his story.The attempt to quantify how many deaths are attributable to medical error began in earnest in 2000 with the Institute of Medicine’s To Err Is Human, which estimated that the death rate due to medical error was 44,000 to 96,000, roughly one to two times the death rate from automobiles. At the time, in response to the study, the quality improvement (QI) revolution began. Every hospital began implementing QI initiatives. Indeed, I was co-director of a statewide QI effort for breast cancer patients for three years. Yet, as Mark Hoofnagle points out in the Twitter thread above, the estimates for “death by medicine” keep increasing. They went from 100,000 to 200,000 and now as high as 400,000. On quack websites, the number is even higher. For instance, über-quack Gary Null teamed with Carolyn Dean, Martin Feldman, Debora Rasio, and Dorothy Smith to write a paper “Death by Medicine,” which estimated that the total number of iatrogenic deaths is nearly 800,000 a year, which would be the number one cause of death, if true and nearly one-third of all deaths in the US. Basically, when it comes to these estimates, it seems as though everyone is in a race to see who can blame the most deaths on medical errors.
Damn @gorskon, I usually cite you.
But I can do a quick tweetorial of my critique.https://sciencebasedmedicine.org/are-medical-errors-really-the-third-most-common-cause-of-death-in-the-u-s/ …
But I can do a quick tweetorial of my critique.https://sciencebasedmedicine.org/are-medical-errors-really-the-third-most-common-cause-of-death-in-the-u-s/ …
Here's the history, the "3rd cause" canard comes from a major frameshift on measuring error, and a questionable algorithmic measurement of error that does not actually detect mistakes but "ripples" in the EMR that are *proxies* for error - ICU admissions, major order changes etc.
See Mark Hoofnagle's other Tweets
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