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To the Editor.—In their meta-analysis on adverse drug reactions (ADRs) in hospitalized patients, Dr Lazarou and colleagues¹ state: "Fatal ADRs appear to be between the fourth and sixth leading cause of death. Their incidence has remained stable over the last 30 years." These 2 sequential sentences indicate the authors claim that their findings regarding fatal ADRs are applicable today. Although the figure in their article shows stability of the total ADR incidence over the years, it does not distinguish fatal ADRs from nonfatal. Plotting only fatal ADRs based on data contained in Tables 1 and 2 of their article shows that the incidence of fatal ADRs has decreased precipitously during the last 30 years (Figure 1).

Figure appears in full text version. Figure 1.—Adverse drug reaction (ADR) deaths reported in 1965 to 1995.

The authors' conclusion that fatal ADRs in the United States number approximately 106,000 annually is erroneous as applied to the . . . [Full Text of this Article]

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