Estimating risk when zero events have been observed
Open accessAbstract
Assessing the risk of complications or adverse events following an intervention presents challenges when they have not yet occurred. Suppose, for instance, a chronic shortage of cardiac telemetry beds has prompted a hospital to implement a new policy that places low-risk patients admitted to ‘rule out myocardial infarction’ in regular ward beds (ie, with no telemetry). After 6 months and the admission of 100 such patients, no cardiac arrests or other untoward events have occurred. This absence of harm (ie, zero adverse events) indicates a low risk, but clearly we cannot infer a risk of zero on the basis of only 100 patients. But, what can we say about the true underlying risk?
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Cites
If nothing goes wrong, is everything all right? Interpreting zero numerators
Hanley, J. A. (1983) · JAMA · doi:10.1001/jama.249.13.1743 · Cited by 1,215 · see citing works
If Nothing Goes Wrong, Is Everything All Right?
Hanley, J. A. (1983) · JAMA · doi:10.1001/jama.1983.03330370053031 · Cited by 1,052 · see citing works
Estimating the Probability of Rare Events: Addressing Zero Failure Data
Quigley, J., & Revie, M. (2011) · Risk Analysis · doi:10.1111/j.1539-6924.2010.01568.x · Cited by 43 · see citing works
Self-citationWhat to do when nothing has happened?
Freeman, R. A. (2011) · Process Safety Progress · doi:10.1002/prs.10463 · Cited by 12 · see citing works
Advances in consenting: the rule of 3 and its modifications for the surgeon
Upile, T., Mahil, J., & Jerjes, W. (2012) · Clinical Otolaryngology · doi:10.1111/j.1749-4486.2012.02449.x · Cited by 1 · see citing works
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- Authors
- Quigley, J., Revie, M., & Dawson, J.
- Affiliations
- University of Strathclyde (GB)
- University of Glasgow (GB)
- Corresponding author
- Revie, Matthew
- Venue
- BMJ Quality & Safety
- Publisher
- BMJ
- Published
- 2013-08-19
- Volume
- 22
- Issue
- 12
- Pages
- 1042-1043
- ISSN
- 1475-3898 (ISSN-L)
- 2044-5415
- 2044-5423
- OpenAlex
- W2108679540
- Cited by
- 11
- References
- 5
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2021: 1 · 2020: 1 · 2019: 2 · 2018: 2
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- Locations
- BMJ Quality & Safety (publishedVersion)
- PubMed (publishedVersion)
- Strathprints: The University of Strathclyde institutional repository (University of Strathclyde) (submittedVersion)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Health Sciences › Health Professions › Emergency Medical Services › Patient Safety and Medication Errors
- Physical Sciences › Mathematics › Statistics and Probability › Probability and Statistical Research
- Keywords
- risk estimation, adverse events, complication risk, cardiac telemetry, myocardial infarction, hospital policy
- MeSH terms
- Quality of Health Care, Risk Management, Scotland, Risk Assessment
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