Andrew Anglemyer, PhD, MPH; Tara Horvath, MA; George Rutherford, MD
Grant Support: None.
Potential Conflicts of Interest: None disclosed. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M13-1301.
Requests for Single Reprints: Andrew Anglemyer, PhD, MPH, University of California, San Francisco, UCSF Box 1224, 50 Beale Street, Suite 1200, San Francisco, CA 94143; e-mail, Andrew.Anglemyer@ucsf.edu.
Current Author Addresses: Drs. Anglemyer and Rutherford and Ms. Horvath: University of California, San Francisco, UCSF Box 1224, 50 Beale Street, Suite 1200, San Francisco, CA 94143.
Author Contributions: Conception and design: A. Anglemyer, G. Rutherford.
Analysis and interpretation of the data: A. Anglemyer, G. Rutherford.
Drafting of the article: A. Anglemyer, T. Horvath.
Critical revision of the article for important intellectual content: A. Anglemyer, G. Rutherford.
Final approval of the article: A. Anglemyer, T. Horvath, G. Rutherford.
Provision of study materials or patients: A. Anglemyer.
Statistical expertise: A. Anglemyer.
Administrative, technical, or logistic support: A. Anglemyer, T. Horvath, G. Rutherford.
Collection and assembly of data: A. Anglemyer, T. Horvath.
This article has been corrected. The original version (PDF) is appended to this article as a Supplement.
Research suggests that access to firearms in the home increases the risk for violent death.
To understand current estimates of the association between firearm availability and suicide or homicide.
PubMed, EMBASE, the Cochrane Central Register of Controlled Trials, and Web of Science were searched without limitations and a gray-literature search was performed on 23 August 2013.
All study types that assessed firearm access and outcomes between participants with and without firearm access. There were no restrictions on age, sex, or country.
Two authors independently extracted data into a standardized, prepiloted data extraction form.
Odds ratios (ORs) and 95% CIs were calculated, although published adjusted estimates were preferentially used. Summary effects were estimated using random- and fixed-effects models. Potential methodological reasons for differences in effects through subgroup analyses were explored. Data were pooled from 16 observational studies that assessed the odds of suicide or homicide, yielding pooled ORs of 3.24 (95% CI, 2.41 to 4.40) and 2.00 (CI, 1.56 to 3.02), respectively. When only studies that used interviews to determine firearm accessibility were considered, the pooled OR for suicide was 3.14 (CI, 2.29 to 4.43).
Firearm accessibility was determined by survey interviews in most studies; misclassification of accessibility may have occurred. Heterogeneous populations of varying risks were synthesized to estimate pooled odds of death.
Access to firearms is associated with risk for completed suicide and being the victim of homicide.
Anglemyer A, Horvath T, Rutherford G. The Accessibility of Firearms and Risk for Suicide and Homicide Victimization Among Household Members: A Systematic Review and Meta-analysis. Ann Intern Med. 2014;160:101–110. doi: https://doi.org/10.7326/M13-1301
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Published: Ann Intern Med. 2014;160(2):101-110.
Emergency Medicine, Healthcare Delivery and Policy, Hospital Medicine.
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