Adverse events in British hospitals: preliminary retrospective record review

Dear Sir,

At first sight the results are alarming.The rate of AEs for Australia-
16.6%,for the UK-10.8% and for the US-3.7%. We concede the importance of
measuring the extent of AEs and taking action to reduce their number.

However the measures used should be reliable and reproducible.It
should be noted that the mortality rates are in the reverse order, with
the US-13.6%, the UK-8% and Australia-4.9%. When charted the figures
provide an almost staight line.

The methodological problem most likely relates to the threshold
determination, with a high threshold for AEs providing small numbers of
serious events and a low threshold large numbers of minor events.This
study weakness is now recognised, but the community, particularly in
Australia and the UK need to be reassured that the health care standards
in their two countries are unlikely to be inferior(to the US) to the
extent suggested by these "comparative" studies.A large difference was in
the "eye" (or attitude)of the reviewers.