Dear Colleagues, A recent article published in the February 20, 2018 edition of Annals of Internal Medicine that purported to review the evidence underpinning the SEP-1 measure has been corrected by the editors of the journal due to misrepresentations of fact. While the article contained several false assertions, perhaps the single correction that exposes the pervasive nature of the inaccuracies was that the editors believed it necessary to change even the title of the publication.
The letter to the editor prompting the correction can be found here: http://annals.org/aim/fullarticle/2675610/evidence-underpinning-centers-medicare-amp-medicaid-services-severe-sepsis-septic Despite these required corrections, the authors maintain their assertion that have reviewed the evidence supporting SEP-1 properly in reaching their conclusions. While this systematic review adjudicated the evidence based upon the assessments of the authors, the limitations of a single-center self-commissioned review without access to all CMS program data are self-revealing. We note that the National Quality Forum which reviewed the measure in 2017 impanels a committee of national experts from a variety of institutions (vetted for conflicts of interest), is transparent, and includes an opportunity for an open notice and comment period to consider external expert and public feedback. In 2017, the NQF committee concluded that the level of evidence supporting the composite measure was "moderate." The measure was ultimately reendorsed with 4, 9, and 0 members evaluating the evidence as high, moderate, and low, respectively. The NQF review was multi-institutional, evaluated the evidence using the most up-to-date standards, and had access to program data that the Annals authors did not review. Sean R. Townsend, M.D. Vice President of Quality & Safety California Pacific Medical Center 2351 Clay Street, 7th Floor San Francisco, CA 94115 email [email protected]<mailto:[email protected]> office (415) 600-5770 fax (415) 600-1541
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