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Resurrecting Treatment Histories of Dead Patients—Reply
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In Reply: Drs Teno and Mor echo our point: that it is not possible to identify in advance patients who will die or to predict accurately when death will occur. If the reason investigators are studying decedents is to improve the quality of care rendered to dying patients, this unpredictability is the basis for our concern. Analyses of decedents are being misused to make inferences about the care delivered to terminally ill patients because decedents would not have necessarily been considered to be terminally ill.
Drs Barnato and Lynn emphasize a related issue: "the events that precipitate dying may be sudden." As a result, care provided over a standardized time period prior to death will likely include care delivered to a patient perceived to have a long life expectancy. Findings may be biased if care rendered to decedents over a fixed time period prior to death is construed as reflecting . . . [Full Text of this Article]
Peter B. Bach, MD, MAPP
bachp@mskcc.org
Deborah Schrag, MD, MPH;
Colin B. Begg, PhD
Health Outcomes Research Group
Memorial Sloan-Kettering Cancer Center
New York, NY
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