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In Rates We Trust

Am J Dis Child. 1993;147(8):813. doi:10.1001/archpedi.1993.02160320015004.
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In this issue, Leland et al1 calculate an injury rate for children in day-care centers that is expressed as the number of injuries per "child day." Computation of such incidence rates helps determine the relative importance of different settings and activities in the occurrence of injury. Rates are also important for evaluating the effect of control measures. However, choosing appropriate numerators and denominators for calculating rates can be difficult.

What constitutes an injury worthy of counting, ie, what belongs in the numerator? Leland et al1 count all injuries, no matter how trivial, as long as they were recorded in a logbook and involved physical or emotional distress. For some purposes, this definition may be useful; however, for public health and epidemiologic purposes, it may be less useful. The reasons are twofold. First, minor injuries, like bumps and scrapes, are difficult to define consistently. Such injuries may be more


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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.
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