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Comment & Response
March 4, 2019

Clarifications Needed on Study of Association Between Physician Burnout and Patient Safety—Reply

Author Affiliations
  • 1National Institute for Health Research School for Primary Care Research, National Institute for Health Research Greater Manchester Primary Care Patient Safety Translational Research Centre, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
JAMA Intern Med. 2019;179(4):593-594. doi:10.1001/jamainternmed.2019.0152

In Reply In response to the letter by Jansen, we acknowledge our study’s1 limitations of pooling cross-sectional data, and we based our sensitivity analyses mostly on prospective studies. The assessment methods of patient safety outcomes were considered in the subgroup analyses. In most studies, physicians were asked to self-report patient safety incidents. A few studies used surveillance methods to assess whether patient safety incidents occurred. However, none of these studies had detailed case note reviews using standardized assessment protocols and independent reviewers, which is the gold-standard approach for investigating the incidence and nature of patient safety incidents and adverse events in the process of health care.2

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