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May 2, 2011

The Hazards of Drawing Conclusions From Before-and-After Studies of System-Level InterventionsKnowing May Not Be Enough

Author Affiliations

Author Affiliations: Departments of Pediatrics (Dr Cabana), Epidemiology and Biostatistics (Dr Cabana), and Medicine (Dr Wachter) and the Philip R. Lee Institute for Health Policy Studies (Dr Cabana), University of California, San Francisco, San Francisco.

Arch Pediatr Adolesc Med. 2011;165(5):472-473. doi:10.1001/archpediatrics.2011.45

Knowing is not enough; we must apply.—Johann Wolfgang von Goethe

In today's health care system, faced with powerful evidence of poor quality1 and high and relatively static rates of errors,2 the impulse to “just do it,” a modern, Madison Avenue version of Goethe's sentiment, can be irresistible. The challenges of knowing when to apply information vs knowing when we know enough are most aptly demonstrated in the rapid response system (RRS).

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