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Ask BMJ to retract the paper 'Medical Error : the third leading cause of death in the US'

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I am Dr Shyam Sabat, MD,  Associate Professor of Neuroradiology at Penn State Hershey, PA. I am also Vice-chair of PA Medical Society Young Physician Section and secretary-treasurer of the Dauphin County Medical Society. 

Dr Virginia Hall, MD, is Associate Professor of OBGYN at Penn State Hershey, PA. She is a past President of Dauphin County Medical Society, Delegate from PA to the AMA House of Delegates and a member of various AMA committees.

Dear BMJ,

The BMJ (formerly the British Medical Journal) published a paper titled “Medical Error: the third leading cause of death in the US” authored by Makary M & Daniel M in its 353th issue dated May 3, 2016. 

The paper, which likely purposefully has a tabloid type spicy headline, has expectedly already garnered widespread attention in the print, online media, TV as well as the blogosphere and social media. The paper is being cited in the media in the same breath as the very famous Institute of Medicine (IOM) 1999 paper titled: “To Err is human.” 

But luckily for the U.S. medical/paramedical personnel and patients (and unfortunately for the authors and publishers), the paper is an extremely shoddy piece of scientific and statistical work which cannot stand the close scrutiny of peer physician researchers and professional statisticians. 

We reviewed the paper with expert statistician Dr. Vernon Chinchilli (Prof and Chair Dept of Public Health Sciences, Penn State College of Medicine), who found it shoddy that the paper which calls itself a meta-analysis of four studies, is actually just a borrowed summary of a single study (by Healthgrades published in 2004). The other three studies just have 795; 838 and 2341 patients respectively versus 37 million in the Healthgrades study and thus don’t have enough statistical power to be clubbed together. So the final conclusion numbers of this so called new meta-analysis study actually belong to the much down-played Healthgrades 2004 study, which consisted of only medicare Medicare patients ( 65 years and above). 

Moreover, the authors borrowed the mortality rates from this Medicare population study and outrageously applied it to all U.S. inpatient admisssions (all ages from 0-100+ years) without any correction of any form. It is common knowledge that the Medicare inpatient population is older, sicker and more vulnerable, and hence will have a higher morbidity and mortality for a given medical error than the general US population. The Healthgrades study had not done any sort of such shoddy projection and hence does not contain these errors. 

How a reputed group such as the BMJ could not see through these simple but outrageous statistical blunders is anyone’s guess. May Did the overwhelming incentive to get a spice tabloid-type, eye-catching headlined paper, prevented the editorial process from taking common sense decisions.? 

The result is that the U.S. medical fraternity is being ridiculed by media and people not only from the US, but the whole world, who cannot understand how U.S. the medical system is so incompetent despite spending the maximum and attracting the best talents from all over the world. 

Few years from now, no one will question how the conclusion in the paper was reached; everyone will just cite the result as if it were some gospel truth. Hence it is important to speak up against this paper right now. 

We demand that the BMJ group immediately retract the paper and issue an apology to counter the blame and shame the U.S. medical fraternity has already received from this reckless paper and the damage done to provider-patient relationship. 

Please support this petition and forwarding it to your physician, PA, CRNP/CRNA, nurse colleagues and other non-medical well-wishers.


                                                                               -  Dr Shyam Sabat

                                                                               - Dr Virginia Hall.

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