In December of 2006, the Public Library of Science (PLoS) published in its peer-reviewed open-access online journal a study on medical errors sponsored by the National Institute for Occupational Safety and Health (part of the US Centers for Disease Control) and the Agency for Healthcare Research and Quality. The study found that sleep-deprived medical residents and interns reported higher incidents of medical errors, some resulting in the deaths of patients.
While the results are not surprising given previous research cited by the authors, the study apparently motivated the U.S. House Energy and Commerce Committee to launch an investigation into preventable medical errors and whether overly long work shifts and sleep-deprivation among physicians, medical residents, and interns are causing serious threats to patient safety, according to an April 11 statement.
All this attention is quite necessary if we are going to get the country to focus on the problem. Even though the study had its limitations (appropriately noted by the researchers) it served its purpose. But what caused me some concern was this little line in the notes appending the article.
“Received: January 5, 2006; Accepted: September 29, 2006; Published: December 12, 2006″
This article — one dealing with errors possibly leading to deaths, and one that has had a national impact — took over 11 months to see the light of day. I know, I know, this not a new issue, and there are all sorts of reasons why this kind of delay takes place including the nature of the peer review process. Journals continually have to be on the lookout for poor quality studies, significant findings not reported and even medical research fraud. And, the PLoS does makes a great contribution to the distribution of scientific knowledge. ( I also do applaud them for showing us the metric here). But given the extraordinary talent and information technology we have in the medical industry, we should be able to do better than this. The review process needs to be examined and rethought. There was a time when this kind of delay for publication was normal and acceptable. That time has passed. Welcome to the future.
