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Editor's Correspondence
June 10, 2013

The Ability of a Retrospective Review of Electronic Health Records to Fully Capture the Frequency of Supratherapeutic Dosing of Acetaminophen—Reply

Author Affiliations

Author Affiliations: Clinical Informatics Research & Development, Partners HealthCare System Inc, Wellesley, Massachusetts, and Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

JAMA Intern Med. 2013;173(11):1035-1036. doi:10.1001/jamainternmed.2013.620

In reply

Dr Charpiat raises valid points. A tendency to underestimate the rate of supratherapeutic dosing would be driven by the proportion of patients studied who were underweight, which we did not measure.1 Weight-based dosing is widely used in children younger than 12 years, but not in the adult population we studied.2 However, we did perform secondary analyses for elderly patients and patients with chronic liver disease, who may be at increased risk of toxic effects from acetaminophen use or have lower therapeutic windows.

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