Matt Bivens, MD, the EMS medical director at St. Luke's Hospital in New Bedford, Mass., and a Harvard Medical Faculty-associated physician, criticized an Agency for Healthcare Research and Quality study on emergency department errors and accused the agency of fearmongering in a March Emergency Medicine News article.
A December 2022 AHRQ report titled "Diagnostic Errors in the Emergency Department: A Systematic Review" contained information detailing how out of 130 million emergency department visits in the U.S. each year, 7.4 million are misdiagnosed, 2.6 million are affected by an adverse event during their visit, and 1 in 350 are affected by worse outcomes: permanent disability or death.
Dr. Bivens called this data "a deeply flawed analysis," and pointed out that based on other information in the report, an emergency department that sees 25,000 visits per year could end up with 50 misdiagnosis-associated deaths annually, which he alleges is too high.
"The claim that we are killing a patient every other day with misdiagnoses is based on three small studies from other countries," Dr. Bivens wrote. "Two of those studies were used to calculate the error rates. Each involved a single hospital, one in Spain, the other in Switzerland. Neither country at that time had emergency medicine residency-trained physicians."
He also asserts that the statistics in the report appear to "target" and place blame on physicians — specifically attributing 89 percent of diagnostic errors to clinical decision-making.
Dr. Bivens wrote that he and others in the profession view the report as "highly misleading" and "unconscionable."
"What about systems-level interventions to prevent diagnostic errors?" he wrote. "Why aren't hospitals incentivized to build surge capacity, for example, for the utterly predictable 'crisis' of an influenza-and-RSV season known as winter?"
Becker's reached out to the AHRQ to request a comment on the matter and a spokesperson said the agency has no comment at this time. This story will be updated should more information become available.
Editor's note: This story was updated at 4:47 p.m. CT May 3 to include an update from AHRQ.