Lenzer, J. BMJ 2016;352:i719
A controversial study of the effects on patient mortality of sleep deprivation among resident physicians that came under fire last year has been criticized again, this time for its publication by the New England Journal of Medicine.
The researchers examined deaths among people cared for by resident doctors who could work duty periods of 28 hours or more (flexible group) and among those cared for by residents who worked 16 to 28 hours in one shift (standard group). All other working conditions were the same in the two groups, including a cap on working more than 80 hours per week, averaged over four weeks.
The non-inferiority, national, cluster randomized study of doctors at 117 general surgery residency programs across the United States found no difference between the two groups in the proportion of postoperative deaths and serious complications at 30 days among patients (9.1% in the flexible group and 9.0% in the standard group (P=0.92); unadjusted odds ratio for the flexible policy group 0.96 (92% confidence interval 0.87 to 1.06), P=0.44; non-inferiority criteria satisfied).
The FIRST (flexibility in duty hour requirements for surgical trainees) trial came under fire in November 2015, when the Health Research Group of the watchdog body Public Citizens and the American Medical Students Association charged that the study was unethical, in part because patients were not told that they were in a study.
Carry on reading the full commentary article here
Read the original research abstract here