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October 11, 2000

Should Patients in Quality-Improvement Activities Have the Same Protections as Participants in Research Studies?

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(14):1786-1788. doi:10.1001/jama.284.14.1783

To the Editor: Dr Casarett and colleagues1 claim that virtually all QI interventions are generalizable. I disagree. How well inpatients at my hospital like the food relates solely to how well inpatients at my hospital like the food and cannot be generalized to another hospital. Contrary to the authors' conclusions, I would describe such an inpatient satisfaction survey as not generalizable and therefore not research. Similarly, a chart review to determine how long patients wait for a procedure at a particular institution is not generalizable. The determination of whether an investigation is generalizable remains an important and usually easily recognized factor that classifies most QI activities as different from research.