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Invited Commentary
November 4, 2019

Reflections on Mortality and Uncertainty in Emergency Medicine

Author Affiliations
  • 1Ronald O. Perelman Department of Emergency Medicine, New York University School of Medicine, New York, NY
  • 2Institute for Innovations in Medical Education, NYU Langone Health, New York, NY
  • 3Department of Population Health, New York University School of Medicine, New York, NY
JAMA Intern Med. Published online November 4, 2019. doi:https://doi.org/10.1001/jamainternmed.2019.4858

Could emergency medicine (EM), which often is characterized as overutilized by patients, criticized as excessive in performing tests, labeled as unjustifiably expensive, and susceptible to diagnostic error, be doing something right? Burke and colleagues1 found that the mortality rate declined considerably among Medicare beneficiaries who had visited an emergency department (ED) from 2009 to 2016, particularly in patients with high-severity conditions. Given the limits of observational studies, the cause of the lower mortality rate is unknown. We suspect that both EM proponents and detractors will use the study’s analysis to validate their own health care policy conclusions.

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