Medical studies: Focus on solutions, not statistics

by Brian Ward

When reading a medical study, providers should focus more on the suggestions and solutions it offers—not just shocking or dramatic statistics, says Brad Truax, MD, a board-certified physician in neurology and internal medicine with over 20 years of experience in medical administration and patient safety. Truax’s comments are in response to a controversial AHRQ study called Diagnostic Errors in the Emergency Department: A Systematic Review. Published in December 2022, the study reported that 5.7% of emergency department (ED) visits result in at least one diagnostic error, of which 2% result in adverse events and 0.03% in serious adverse events.

These statistics generated a lot of headlines in The New York Times, The Boston Globe, CNN, and other outlets on the need to improve EDs. It also quickly generated pushback and condemnation from people pointing out the study’s many flaws.

“CNN reported that the authors ‘reviewed nearly 300 studies’ from the past 20 years. But the fine print—or at least the second bullet point in the abstract!—specifies that ‘overall error and harm rates are derived from three smaller studies conducted outside the United States,’ ” reported Emergency Medicine News; those smaller studies came from Canada, Spain, and Switzerland.

There were other complaints about the study, including how it characterized ED providers as a root cause of error.

“The statistics do little to help us improve patient safety,” Truax wrote in a blog. “Rather, we must look at the real opportunities to improve patient safety. The more important questions to ask [about diagnostic errors] are ‘What are the serious conditions that are more likely to be missed?’ and ‘What are the presenting symptoms that often lead to missed diagnoses?’ [And] when seeing patients in any healthcare venue, the two most important questions we usually ask ourselves are ‘What could I be missing?’ and ‘What’s the most serious thing I could be missing?’ ”

For more on this story, hop over to Patient Safety Monitor Journal to read Focus on medical study solutions, not the dramatic statistics.