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ARTICLE |

Systems Analysis of Adverse Drug Events FREE

Nancy W. Dickey, MD; Martin J. Hatlie, JD
JAMA. 1996;275(1):33-33. doi:10.1001/jama.1996.03530250037017
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To the Editor.  —There is no question that the contributions made by Dr Bates and colleagues1 and Dr Leape and colleagues2 are important to our knowledge and understanding of adverse drug events. Their research could make a real difference in the health care community's ability to deliver better and safer medical care.However, it is unfortunate that the authors needlessly chose to dramatize their work by making sweeping, scientifically invalid estimates regarding annual rates of iatrogenic injuries and deaths numbering in the millions and hundreds of thousands, respectively. It is simply not scientifically possible to estimate current national iatrogenic injury and death rates based solely on the Harvard Medical Practice Study's (MPS's) decade-old sample of patient discharge records, which included only one state (New York) during just 1 year (1984).3We have no desire to minimize the extent or nature of medical injuries, but we are concerned

REFERENCES

Bates DW, Cullen DJ, Laird N, et al.  Incidence of adverse drug events and potential adverse drug events: implications for prevention. JAMA . 1995;;274:29-34.
Leape LL, Bates DW, Cullen DJ, et al.  Systems analysis of adverse drug events. JAMA . 1995;;274:35-43.
Brennan TA, Leape LL, Laird N, et al.  Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. N Engl J Med . 1991;;324:370-376.
Eichhorn JH.  Risk reduction in anesthesia. Probl Anesthesia . 1992;;6:278-294.
Taulbee P.  Maryland Quality Project Puts New Focus on Processes of Care. Rep Med Guideline Outcomes Res . 1994;;5( (6) ):10-11.
Harpole D.  Deep vein thrombosis and pulmonary embolism in surgical patients. Forum . 1994;;15:9-11.

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

Bates DW, Cullen DJ, Laird N, et al.  Incidence of adverse drug events and potential adverse drug events: implications for prevention. JAMA . 1995;;274:29-34.
Leape LL, Bates DW, Cullen DJ, et al.  Systems analysis of adverse drug events. JAMA . 1995;;274:35-43.
Brennan TA, Leape LL, Laird N, et al.  Incidence of adverse events and negligence in hospitalized patients: results of the Harvard Medical Practice Study I. N Engl J Med . 1991;;324:370-376.
Eichhorn JH.  Risk reduction in anesthesia. Probl Anesthesia . 1992;;6:278-294.
Taulbee P.  Maryland Quality Project Puts New Focus on Processes of Care. Rep Med Guideline Outcomes Res . 1994;;5( (6) ):10-11.
Harpole D.  Deep vein thrombosis and pulmonary embolism in surgical patients. Forum . 1994;;15:9-11.
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To understand the clinical management of acute heart failure syndromes.
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