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An interesting study is making the rounds in the mainstream media. Instapundit, Scientific American, NBC News, Healthcare Business Tech Blog, MedPage Today, CBS Atlanta, and Consumer Reports have all reported on the study. Unfortunately, the study draws questionable conclusions. A group of scientists at the University of Geneva Hospitals (Switzerland) and affiliated with the World Health Organization recently published a study demonstrating that physicians’ stethoscopes harbor many bacteria. The study was titled “Contamination of Stethoscopes and Physicians’ Hands After a Physical Examination” and was published in this months’ Mayo Clinic Proceedings. First, the researchers note that physician stethoscopes can be contaminated after a physical examination. Agreed. The amount of contamination can be as much as that contained on the palm of the hand (but not the fingertips). OK wonderful. The number of colonies causing the level of contamination is “substantial” after a single physical exam. For fingertips, the average number of colony forming units transferred was 467. For stethoscopes, the average number of colony forming units transferred was 89. Not so sure that is “substantial,” but we’ll go with it. For MRSA carriers, the average number of CFUs transferred was 12 for the fingertips and 7 for the stethoscope. However … no transfer of any MRSA bacteria occurred in 24% of patients and the researchers just discarded the data from those patients for the final analysis. (“Because MRSA was not recovered from the physicians’ dominant hand or the stethoscope after the examination of 12 of 50 patients colonized with MRSA (24%), these patients were excluded from the final analysis”). Averaging in a bunch of data that don’t fit with their conclusions would only dilute their message. Then come the “scientific” conclusions: “By considering that stethoscopes are used repeatedly over the course of a day, come directly into contact with patients’ skin, and may harbor several thousands of bacteria (including MRSA) collected during a previous physical examination, we consider them as potentially significant vectors of transmission. Thus, failing to disinfect stethoscopes could constitute a serious patient safety issue akin to omitting hand hygiene.” Note the hypothetical pseudoscience contained in just these two sentences. Stethoscopes “MAY harbor several thousands of bacteria” – meaning that stethoscopes also “may NOT harbor” several thousands of bacteria and you haven’t proven anything. “WE consider them as potentially significant” – ah, the logical fallacy of an appeal to authority. WE are published in a national journal and are getting national media attention. No one else might consider them as potentially significant, but those who do not agree with US are obviously unqualified to make such decisions. Oh, and by the way, WE still haven’t shown any literature proving this point, so just believe our pseudoscience and move along. “THUS …” – a haughty prelude showing that you are trying to use your unfounded conclusions to get everyone to believe your ultimate point that … “failing to disinfect stethoscopes COULD constitute a serious patient safety issue” – BRILLIANT! Oh, and by the way, the moon COULD be made out of green cheese, the government COULD be putting nanobots in our vaccines, Juan Pablo COULD marry any woman he wanted on the Bachelor, and I COULD win the lottery. Without better research, there is no way to determine whether any of these possibilities is more likely to occur than any other of the possibilities. A scientific statement that something “COULD” occur is close to being meaningless, showing only the absence of an impossibility. The likelihood of that event occurring is anywhere between 0.0000000000000000001% and 100%. There are multiple parallel studies which also make leaps in logic about the possibility ...Read More »