Author Contributions: Dr Wharam had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Wharam, Landon, Galbraith, Soumerai, Ross-Degnan.
Acquisition of data: Wharam, Galbraith, Soumerai.
Analysis and interpretation of data: Wharam, Landon, Galbraith, Kleinman, Soumerai, Ross-Degnan.
Drafting of the manuscript: Wharam.
Critical revision of the manuscript for important intellectual content: Wharam, Landon, Galbraith, Kleinman, Soumerai, Ross-Degnan.
Statistical analysis: Wharam, Kleinman, Soumerai, Ross-Degnan.
Obtained funding: Wharam, Galbraith.
Administrative, technical, or material support: Wharam, Soumerai.
Study supervision: Landon, Soumerai, Ross-Degnan.
Financial Disclosures: Drs Galbraith and Soumerai have received grant support from the Harvard Pilgrim Health Care Foundation.
Funding/Support: The study was supported by a faculty grant funded by the Harvard Pilgrim Health Care Foundation. Dr Wharam's salary was funded by the General Internal Medicine Faculty Development Program from the Health Resources and Services Administration, by an Institutional National Research Service Award (July 2004 to June 2006), and by the Thomas O. Pyle fellowship, funded by Harvard Medical School and Harvard Pilgrim Health Care Department of Ambulatory Care and Prevention (July 2006 to present). Drs Soumerai and Ross-Degnan were also investigators in the HMO Research Network Centers for Education and Research on Therapeutics Prescribing Safety Study (Agency for Healthcare Research and Quality cooperative agreement U 18 HS 11843; principal investigator: Richard Platt).
Role of the Sponsor: The funding source had no role in the design and conduct of the study; in the collection, management, analysis, and interpretation of the data; or in the preparation, review, and approval of the manuscript.
Acknowledgment: We acknowledge the helpful assistance in statistical analysis and interpretation of Fang Zhang, PhD, and assistance with data collection by Irina Miroshnik, MS, both of the Harvard Medical School and Harvard Pilgrim Health Care Department of Ambulatory Care and Prevention. We are also grateful to David Cochran, MD, Harvard Pilgrim Health Care's senior vice president of strategic development, and many others at Harvard Pilgrim Health Care for providing access to data and technical support.