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Comment & Response
November 25, 2013

Firearm Legislation and Gun-Related Fatalities—Reply

Author Affiliations
  • 1Division of Emergency Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2013;173(21):2011-2012. doi:10.1001/jamainternmed.2013.9957

In Reply Jena and colleagues address the concern of an apparent rise in nonfatal gunshot injuries in the United States from 2002 to 2011, as reported in the Web-Based Injury Statistics Query and Reporting System (WISQARS) database. The methodology for collecting firearm fatality data differs from that for nonfatal injury data; the differences effect the interpretation of the data.

By law, every state must provide information about deaths within its borders; thus, the accuracy of the firearm fatality data are considered excellent. However, rates of nonfatal firearm injuries are estimates based on data collected from a stratified probability sample of 66 US hospitals that participate in the National Electronic Injury Surveillance System–All Injury Program (NEISS-AIP). Although rates of nonfatal firearm injuries appear to have increased from 2002 to 2011, the uncertainty in the estimates precludes definitive conclusions. Improvements in the delivery of trauma care may have contributed to a stable injury fatality rate over the decade; however, this is an open question requiring further study.