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Invited Commentary
Health Care Reform
June 28, 2010

Diagnostic Adverse Events: On to Chapter 2: Comment on “Patient Record Review of the Incidence, Consequences, and Causes of Diagnostic Adverse Events”

Author Affiliations

Author Affiliations: Department of Internal Medicine, University of Texas at Houston—Memorial Hermann Center for Healthcare Quality and Safety, The University of Texas Medical School, Houston (Dr Thomas); and CVS Caremark, Woonsocket, Rhode Island (Dr Brennan).

Arch Intern Med. 2010;170(12):1021-1022. doi:10.1001/archinternmed.2010.156

For almost 3 decades, researchers have been trying to understand iatrogenic injuries through large-scale review of medical records. Studies in the United States in California, New York, Utah, and Colorado have been followed by similar investigations in Great Britain, Canada, New Zealand, Spain, and now, with the publication of the report by Zwaan et al, the Netherlands. These studies generally use nurse review of explicit criteria followed by multiple physician implicit review. Zwaan et al found that, overall, about 5% of hospital stays result in an AE, ie, a patient injury or a prolongation of the hospital stay, due to medical management as opposed to the disease process.

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