A possible mechanism of polymerization of tetracyanoethylene

Why Has Evidence of Error-Filled Diagnostic Medicine Not Led Changes Within the Profession?

“…Garland's research on the accuracy of radiologic and other diagnostic procedures revealed a "surprising degree of inaccuracy" including "a 34% error rate in the diagnosis of myocardial infarction," an "agreement rate of only 7% among five experienced pediatricians" in the diagnosis of malnutrition in children, and "a 28% error rate among clinical laboratories in measuring the erythrocyte count" [2]. Another of Garland's striking findings was a 30 percent disagreement rate among experienced radiologists in diagnosing pulmonary tuberculosis [2]. When Garland's studies were published in the 1940s and '50s, the high rates of error and disagreement within the profession came as a shock to physicians and were described by a personal friend of the author's as "morally disturbing" [2, 3].…”

“…In the years since Garland's research was published, other investigators have confirmed his findings. Studies of radiological technologies, such as the mammogram, have shown similarly high rates of inconsistencies [2]. Something not taken into account in this discussion of error rates is that, even though the proportion of errors remains the same, the increased use of many diagnostic procedures has benefited the overall health of more people.…”

“…When Garland's studies were published in the 1940s and '50s, the high rates of error and disagreement within the profession came as a shock to physicians and were described by a personal friend of the author's as "morally disturbing" [2, 3]. Berlin does not offer detailed discussion of Garland's explanation for the rate of error and variability among clinicians, simply noting that he attributed much of the error in radiologic diagnosis to basic human variation and the "still unexplained human equation" [2].…”

“…The article explains how, if the denominator in the error rate calculation is the total number of patients screened, the error rate is bound to appear to be far lower than if the denominator is the number of patients who are positive for a given condition. In both cases the numerator is the sum of the missed positives and the false positives [2]. Moreover, some studies of medical error rates are not taken from the clinical arena but, for example, are conducted by giving a group of physicians a number of abnormal samples and calculating the error rate based on their performance [5].…”