The zeal to rapidly implement quality measures to improve patient care has had some unintended consequences.
Bob Wachter writes about the latest episode, namely, tight control of glucose in intensive care patients.
Initial studies in 2001 showed a marked improvement in mortality when sugars were closely monitored, but since then, recent data has actually concluded the opposite.
Citing a recent NEJM study, not only were deaths, most commonly from severe hypoglycemia, increased, but Dr. Wachter also notes that the resources needed to monitor sugars that closely rapidly padded health care costs.
So, while it is preferable for more doctors to adopt evidence-based practices, we’re now realizing how difficult that could be. It often takes 10 to 15 years for the literature to “mature,” and there are now several cases where follow-up studies have shown that what was initially thought to help patients, actually led to their harm.
