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Adverse Events: The More You Search, the More You Find

John P.A. Ioannidis, MD; Cynthia D. Mulrow, MD, MSc, Deputy Editor; and Steven N. Goodman, MD, PhD
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From the University of Ioannina School of Medicine, Ioannina 45110, Greece; American College of Physicians, Philadelphia, PA 19106; and Johns Hopkins School of Medicine, Baltimore, MD 21205.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: John P.A. Ioannidis, MD, Clinical Trials and Evidence-Based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina 45110, Greece; e-mail, jioannid@cc.uoi.gr.

Current Author Addresses: Dr. Ioannidis: Clinical Trials and Evidence-Based Medicine Unit, Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina 45110, Greece.

Dr. Mulrow: American College of Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106.

Dr. Goodman: Division of Biostatistics, Johns Hopkins Sidney Kimmel Cancer Center, Suite 1103, 550 North Broadway, Baltimore, MD 21205.

Ann Intern Med. 2006;144(4):298-300. doi:10.7326/0003-4819-144-4-200602210-00013
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People want reliable information about potential harms of medications. Concerns about possible adverse effects guide therapy selections, and unpleasant surprises about unsuspected harms cause anxiety and make headlines (1). We often rely on compendia and product inserts for information about such effects. These materials offer litanies of possible adverse events, sometimes accompanied by an estimate of how often those events might occur. From whence are these estimates derived? What do they really mean? How can we better measure and understand how many and what kinds of harms may be caused by medications?

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