3 ms·

I see the “the false positives is okay” sentiment widely here. Just keep in mind that medical mistakes is the 3rd leading cause of death in the US. It’s statist

I see the “the false positives is okay” sentiment widely here. Just keep in mind that medical mistakes is the 3rd leading cause of death in the US. It’s statistically in your favor to limit your exposure to medical mistakes. https://www.google.com/amp/s/www.cnbc.com/amp/2018/02/22/medical-errors-third-leading-cause-of-death-in-america.html https://www.google.com/amp/s/www.cnbc.com/amp/2018/02/22/med...

solidblu 6y ago
So you are suggesting we don't go to the doctor for the leading cause of death because of the 3rd leading risk? Damned if you do, Damned if you don't.
dahart 6y ago
It's complicated and IMO misleading to claim medical mistakes are the 3rd leading "cause" of death as if it's a fact and as if there are clear and better alternatives. No question there are mistakes and room for improvement, but you're linking to meta-studies where people decide what "mistake" means, not a recognized system of categorizing causes of death. I feel like the wording is vaguely implying general malfeasance, while the studies you linked to actually include categories of mistakes that are sometimes unavoidable and sometimes have very unclear lines of responsibility relative to the patient. For example, "One example of a lethal error of communication between provider and patient occurred when cardiologists failed to warn their 19-year-old patient not to run. The patient had experienced syncope while running, and 5 days of inpatient, diagnostic testing were inconclusive; however, his cardiologists knew he was not ready to return to running but failed to warn him against this risk. Having not been warned against running, he resumed running and died 3 weeks later while running." https://journals.lww.com/journalpatientsafety/Fulltext/2013/09000/A_New,_Evidence_based_Estimate_of_Patient_Harms.2.aspx https://journals.lww.com/journalpatientsafety/Fulltext/2013/... This categorization assigns 100% of the blame to a cardiologist who was not performing a procedure and who did not know that the patient would die. The patient chose to do something for which they'd recently experienced issues with, without waiting for complete test results or clear instructions. It's an accident, and unfortunate, but my point is it's very problematic to conclude that the cause of death here is a medical mistake, rather than a heart condition. This is the representative example that the Journal of Patient Safety uses to illustrate communication errors, so it seems reasonable to assume there are many such examples. Furthermore, how many people would be dying if there was no care instead? Probably a lot more, and that's not accounted for. To call mistakes the 3rd leading cause of death, I think we need to account for how many people were saved by medical care too... and when you think about it that way I suspect it's complicated if not impossible to tally that number, meaning that it's also complicated if not impossible to rank medical accidents as a cause of death against objectively identifiable categories like heart attack vs car accident.
Ancapistani 6y ago
I don’t have the statistics in front of me, but at one point I sourced them and was able to show that the risk of a child two years old or younger drowning in a bucket was significantly higher than being unintentionally killed with a firearm. Following your logic here, if you have a toddler and a bucket at home, it would reduce your toddler’s overall risk profile if you bought a gun and shot holes in the bucket. In other words, there’s a lot more that goes into using statistics to inform behavior than merely seeing what group you happen to be included in for a single breakdown.

solidblu 6y ago

So you are suggesting we don't go to the doctor for the leading cause of death because of the 3rd leading risk? Damned if you do, Damned if you don't.

dahart 6y ago

It's complicated and IMO misleading to claim medical mistakes are the 3rd leading "cause" of death as if it's a fact and as if there are clear and better alternatives. No question there are mistakes and room for improvement, but you're linking to meta-studies where people decide what "mistake" means, not a recognized system of categorizing causes of death. I feel like the wording is vaguely implying general malfeasance, while the studies you linked to actually include categories of mistakes that are sometimes unavoidable and sometimes have very unclear lines of responsibility relative to the patient. For example, "One example of a lethal error of communication between provider and patient occurred when cardiologists failed to warn their 19-year-old patient not to run. The patient had experienced syncope while running, and 5 days of inpatient, diagnostic testing were inconclusive; however, his cardiologists knew he was not ready to return to running but failed to warn him against this risk. Having not been warned against running, he resumed running and died 3 weeks later while running." https://journals.lww.com/journalpatientsafety/Fulltext/2013/09000/A_New,_Evidence_based_Estimate_of_Patient_Harms.2.aspx https://journals.lww.com/journalpatientsafety/Fulltext/2013/... This categorization assigns 100% of the blame to a cardiologist who was not performing a procedure and who did not know that the patient would die. The patient chose to do something for which they'd recently experienced issues with, without waiting for complete test results or clear instructions. It's an accident, and unfortunate, but my point is it's very problematic to conclude that the cause of death here is a medical mistake, rather than a heart condition. This is the representative example that the Journal of Patient Safety uses to illustrate communication errors, so it seems reasonable to assume there are many such examples. Furthermore, how many people would be dying if there was no care instead? Probably a lot more, and that's not accounted for. To call mistakes the 3rd leading cause of death, I think we need to account for how many people were saved by medical care too... and when you think about it that way I suspect it's complicated if not impossible to tally that number, meaning that it's also complicated if not impossible to rank medical accidents as a cause of death against objectively identifiable categories like heart attack vs car accident.

Ancapistani 6y ago

I don’t have the statistics in front of me, but at one point I sourced them and was able to show that the risk of a child two years old or younger drowning in a bucket was significantly higher than being unintentionally killed with a firearm. Following your logic here, if you have a toddler and a bucket at home, it would reduce your toddler’s overall risk profile if you bought a gun and shot holes in the bucket. In other words, there’s a lot more that goes into using statistics to inform behavior than merely seeing what group you happen to be included in for a single breakdown.