Patient Safety under Flexible and Standard Duty-Hour Rules
To the Editor: In the iCOMPARE (Individualized Comparative Effectiveness of Models Optimizing Patient Safety and Resident Education) trial, Silber et al. (March 7 issue) 1 prespecified an unreasonable noninferiority threshold based on an increase in 30-day mortality from 12.5% to 13.5%. Even the hig...
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| Veröffentlicht in: | The New England journal of medicine 2019-06, Vol.380 (24), p.2379-2381 |
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| container_issue | 24 |
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| container_title | The New England journal of medicine |
| container_volume | 380 |
| creator | Landrigan, Christopher P Czeisler, Charles A Squiers, John J Lauterbach, Gerhard P Valente, Fernando S Nunes, Maria P.T Silber, Jeffrey H Tonascia, James Asch, David A |
| description | To the Editor:
In the iCOMPARE (Individualized Comparative Effectiveness of Models Optimizing Patient Safety and Resident Education) trial, Silber et al. (March 7 issue)
1
prespecified an unreasonable noninferiority threshold based on an increase in 30-day mortality from 12.5% to 13.5%. Even the highest estimates
2
would project that fewer than a quarter of deaths (and probably far fewer) in hospitals are due to medical errors.
2,3
An absolute increase of 1 percentage point in error-related mortality (i.e., from approximately 3% to approximately 4%) would therefore represent an increase of more than 30% in error-related mortality. It was unreasonable to set such a . . . |
| doi_str_mv | 10.1056/NEJMc1905064 |
| format | Article |
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In the iCOMPARE (Individualized Comparative Effectiveness of Models Optimizing Patient Safety and Resident Education) trial, Silber et al. (March 7 issue)
1
prespecified an unreasonable noninferiority threshold based on an increase in 30-day mortality from 12.5% to 13.5%. Even the highest estimates
2
would project that fewer than a quarter of deaths (and probably far fewer) in hospitals are due to medical errors.
2,3
An absolute increase of 1 percentage point in error-related mortality (i.e., from approximately 3% to approximately 4%) would therefore represent an increase of more than 30% in error-related mortality. It was unreasonable to set such a . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJMc1905064</identifier><identifier>PMID: 31189044</identifier><language>eng</language><publisher>United States: Massachusetts Medical Society</publisher><subject>Conflicts of interest ; Fees & charges ; Humans ; Medical errors ; Mortality ; Patient Safety ; Patients ; Personnel Staffing and Scheduling ; Pharmaceuticals ; Physicians ; Workload</subject><ispartof>The New England journal of medicine, 2019-06, Vol.380 (24), p.2379-2381</ispartof><rights>Copyright © 2019 Massachusetts Medical Society. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c647t-88aa9d02ef626415df960072517a8005f30c6805618eed19d1de6978711cfe763</citedby><cites>FETCH-LOGICAL-c647t-88aa9d02ef626415df960072517a8005f30c6805618eed19d1de6978711cfe763</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.nejm.org/doi/pdf/10.1056/NEJMc1905064$$EPDF$$P50$$Gmms$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2239268195?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>230,314,780,784,885,2757,2758,26102,27923,27924,52381,54063,64384,64386,64388,72240</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31189044$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Landrigan, Christopher P</creatorcontrib><creatorcontrib>Czeisler, Charles A</creatorcontrib><creatorcontrib>Squiers, John J</creatorcontrib><creatorcontrib>Lauterbach, Gerhard P</creatorcontrib><creatorcontrib>Valente, Fernando S</creatorcontrib><creatorcontrib>Nunes, Maria P.T</creatorcontrib><creatorcontrib>Silber, Jeffrey H</creatorcontrib><creatorcontrib>Tonascia, James</creatorcontrib><creatorcontrib>Asch, David A</creatorcontrib><title>Patient Safety under Flexible and Standard Duty-Hour Rules</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>To the Editor:
In the iCOMPARE (Individualized Comparative Effectiveness of Models Optimizing Patient Safety and Resident Education) trial, Silber et al. (March 7 issue)
1
prespecified an unreasonable noninferiority threshold based on an increase in 30-day mortality from 12.5% to 13.5%. Even the highest estimates
2
would project that fewer than a quarter of deaths (and probably far fewer) in hospitals are due to medical errors.
2,3
An absolute increase of 1 percentage point in error-related mortality (i.e., from approximately 3% to approximately 4%) would therefore represent an increase of more than 30% in error-related mortality. It was unreasonable to set such a . . .</description><subject>Conflicts of interest</subject><subject>Fees & charges</subject><subject>Humans</subject><subject>Medical errors</subject><subject>Mortality</subject><subject>Patient Safety</subject><subject>Patients</subject><subject>Personnel Staffing and Scheduling</subject><subject>Pharmaceuticals</subject><subject>Physicians</subject><subject>Workload</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqNkc1v1DAQxS1ExW4LN84oEhx6IGXGsR27B6SqdNui8iEWzpYbTyCrfLR2gtj_vq62rRbEoXOYOcxPTzPvMfYS4QBBqnefTz5-qtCABCWesDnKosiFAPWUzQG4zkVpihnbjXEFqVCYZ2xWIGoDQszZ4Vc3NtSP2dLVNK6zqfcUskVLf5rLljLX-2w5pu6Czz5M4zo_G6aQfZtais_ZTu3aSC_u5h77sTj5fnyWX3w5PT8-usgrJcox19o544FTrbgSKH1tFEDJJZZOA8i6gErp9AlqIo_GoydlSl0iVjWVqthj7ze6V9NlR75K1wbX2qvQdC6s7eAa-_emb37Zn8NvWwqQEngS2L8TCMP1RHG0XRMralvX0zBFy7ngGrk0xWNR0OaRKAp9e8Drf9BVcrFPpiWqMFxpNDJRbzdUFYYYA9UPLyLY26jtdtQJf7VtywN8n20C3myArou2p1X3f50bzeWrnw</recordid><startdate>20190613</startdate><enddate>20190613</enddate><creator>Landrigan, Christopher P</creator><creator>Czeisler, Charles A</creator><creator>Squiers, John J</creator><creator>Lauterbach, Gerhard P</creator><creator>Valente, Fernando S</creator><creator>Nunes, Maria P.T</creator><creator>Silber, Jeffrey H</creator><creator>Tonascia, James</creator><creator>Asch, David A</creator><general>Massachusetts Medical Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BEC</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HCIFZ</scope><scope>K0Y</scope><scope>LK8</scope><scope>M0R</scope><scope>M0T</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2P</scope><scope>M7P</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190613</creationdate><title>Patient Safety under Flexible and Standard Duty-Hour Rules</title><author>Landrigan, Christopher P ; Czeisler, Charles A ; Squiers, John J ; Lauterbach, Gerhard P ; Valente, Fernando S ; Nunes, Maria P.T ; Silber, Jeffrey H ; Tonascia, James ; Asch, David A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c647t-88aa9d02ef626415df960072517a8005f30c6805618eed19d1de6978711cfe763</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Conflicts of interest</topic><topic>Fees & charges</topic><topic>Humans</topic><topic>Medical errors</topic><topic>Mortality</topic><topic>Patient Safety</topic><topic>Patients</topic><topic>Personnel Staffing and Scheduling</topic><topic>Pharmaceuticals</topic><topic>Physicians</topic><topic>Workload</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Landrigan, Christopher P</creatorcontrib><creatorcontrib>Czeisler, Charles A</creatorcontrib><creatorcontrib>Squiers, John J</creatorcontrib><creatorcontrib>Lauterbach, Gerhard P</creatorcontrib><creatorcontrib>Valente, Fernando S</creatorcontrib><creatorcontrib>Nunes, Maria P.T</creatorcontrib><creatorcontrib>Silber, Jeffrey H</creatorcontrib><creatorcontrib>Tonascia, James</creatorcontrib><creatorcontrib>Asch, David A</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Pharma and Biotech Premium PRO</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>New England Journal of Medicine</collection><collection>ProQuest Biological Science Collection</collection><collection>Consumer Health Database</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The New England journal of medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Landrigan, Christopher P</au><au>Czeisler, Charles A</au><au>Squiers, John J</au><au>Lauterbach, Gerhard P</au><au>Valente, Fernando S</au><au>Nunes, Maria P.T</au><au>Silber, Jeffrey H</au><au>Tonascia, James</au><au>Asch, David A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient Safety under Flexible and Standard Duty-Hour Rules</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>2019-06-13</date><risdate>2019</risdate><volume>380</volume><issue>24</issue><spage>2379</spage><epage>2381</epage><pages>2379-2381</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><abstract>To the Editor:
In the iCOMPARE (Individualized Comparative Effectiveness of Models Optimizing Patient Safety and Resident Education) trial, Silber et al. (March 7 issue)
1
prespecified an unreasonable noninferiority threshold based on an increase in 30-day mortality from 12.5% to 13.5%. Even the highest estimates
2
would project that fewer than a quarter of deaths (and probably far fewer) in hospitals are due to medical errors.
2,3
An absolute increase of 1 percentage point in error-related mortality (i.e., from approximately 3% to approximately 4%) would therefore represent an increase of more than 30% in error-related mortality. It was unreasonable to set such a . . .</abstract><cop>United States</cop><pub>Massachusetts Medical Society</pub><pmid>31189044</pmid><doi>10.1056/NEJMc1905064</doi><tpages>3</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0028-4793 |
| ispartof | The New England journal of medicine, 2019-06, Vol.380 (24), p.2379-2381 |
| issn | 0028-4793 1533-4406 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7405502 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; ProQuest Central UK/Ireland; New England Journal of Medicine |
| subjects | Conflicts of interest Fees & charges Humans Medical errors Mortality Patient Safety Patients Personnel Staffing and Scheduling Pharmaceuticals Physicians Workload |
| title | Patient Safety under Flexible and Standard Duty-Hour Rules |
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