Process without progress: emergency medicine, patient safety, and the need for science.

摘要: Often paraphrased as “science is a way of trying not to fool yourself,” the above quote comes from Nobel Prize–winning physicist Richard Feynman’s 1974 address California Institute Technology graduates. In this issue Annals, DeLuca et al presents review automated external defibrillator misadventures that have been reported Food and Drug Administration (FDA) through Manufacturer User Facility Device Experience (MAUDE) database. This article discusses patient safety research in emergency medicine how avoid fooling yourself. Databases such MAUDE appear inspire confidence. They’re repositories for data, data suggest science at work. Programs seem put faith databases solution. For example, organizations are encouraged funnel their reports national The Office National Coordinator Health Information recently proposed creation an information technology problems database solution risks health care technology. Data aggregations account events misadventures. But context formed event gave it meaning missing. How can we trust our view what happened without understanding context? Context also effort. FDA cautions “MAUDE [are] intended be used either evaluate rates adverse or compare across devices.” good reason. Submitting report may voluntary. We can’t know true number really did occur. And verified, so no whether actually true. essay uses which defibrillators were malfunction. It notes mandates reporting when using device results