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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: Dr Dial and colleagues have reported on the rate of Clostridium difficile–associated disease (CDAD) in the United Kingdom.¹ Their study is notable because this is the first time that pathology laboratory data from the UK General Practice Research Database (GPRD) have been used as an outcome of interest in a pharmacoepidemiological study. Moreover, the study may have important clinical implications.

As the authors acknowledge, the striking exponential rise in the rate of community-acquired CDAD diagnosed since 1994 may be partly due to increased reporting and testing. However, there have been major changes in the UK health care system and GPRD in the reporting and collection of CDAD that need to be considered when interpreting the results. In the UK, data from the local pathology laboratory are either sent to a general practice via an electronic link and then loaded in the patient's record electronically, or sent . . . [Full Text of this Article]

Tjeerd-Pieter van Staa, MD, PhD
tjeerd.vanstaa@mhra.gsi.gov.uk
General Practice Research Database
London, England

Frank de Vries, MSc; Hubert G. M. Leufkens, PhD
Utrecht Institute for Pharmaceutical Sciences
Utrecht University
Utrecht, the Netherlands

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