0
The Pediatric Forum |

Sometimes Zero Risk Is Not an Option

Carrie Daymont, MD, MSCE
Arch Pediatr Adolesc Med. 2011;165(6):573-574. doi:10.1001/archpediatrics.2011.75.
Text Size: A A A
Published online

Extract

I read with interest the Christakis editorial “Predictably Unhelpful: Why Clinicians Do Not Use Prediction Rules.”1 I agree with much of the editorial. However, I disagree that once a physician is concerned about a condition the degree of risk is not important.

A risk of 0.001% of a serious bacterial infection corresponds to a risk of 1 in 100 000. The risks associated with evaluating and treating 99 999 infants who do not have a serious bacterial infection to avoid missing the one who does are not negligible. There would be 99 999 well babies who would receive unnecessary venipuncture and likely unnecessary bladder catheterization, lumbar puncture, intravenous antibiotic administration, and hospitalization as well. The risk of adverse effects from any of these common procedures and medications is certainly very low, but each carries a risk that is likely higher than 1 in 100 000.28 The combined risk is even higher.

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
/>
First page PDF preview

Figures

Tables

References

Correspondence

CME
Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature
Clinical Resolution

Users' Guides to the Medical Literature
Clinical Scenario

brightcove.createExperiences();