Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor
In Reply.—Dr Fremont-Smith suggests that our rates of fatal ADRs are too high based on 2 lines of evidence. First, he argues that our fatality rate is exaggerated because we used data obtained over 32 years to estimate the 1994 incidence. To support this assertion he provides a graph demonstrating an apparent decrease in incidence of fatal ADRs over time. However, the sample size is small. We have recent evidence with a much larger sample size that supports our contention that fatal ADRs have not changed over time. Based on data from a new study in which we combined data from the United States with those from other industrialized countries, we show by linear regression that the incidence of fatal ADRs has remained stable over time (Figure 2). Hence, it is unlikely that we exaggerated the rate of fatal ADRs by using the average incidence obtained from the 32 years of data.
Lazarou J, Pomeranz BH, Corey PN. Adverse Drug Reactions in Hospitalized Patients—Reply. JAMA. 1998;280(20):1741. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-20-jac80013