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Comment & Response |

Firearm Legislation and Gun-Related Fatalities—Reply

Eric W. Fleegler, MD, MPH1; Michael Monuteaux, PhD1; Rebekah Mannix, MD, MPH1
[+] Author Affiliations
1Division of Emergency Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2013;173(21):2011-2012. doi:10.1001/jamainternmed.2013.9957.
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In Reply Jena and colleagues address the concern of an apparent rise in nonfatal gunshot injuries in the United States from 2002 to 2011, as reported in the Web-Based Injury Statistics Query and Reporting System (WISQARS) database. The methodology for collecting firearm fatality data differs from that for nonfatal injury data; the differences effect the interpretation of the data.

By law, every state must provide information about deaths within its borders; thus, the accuracy of the firearm fatality data are considered excellent. However, rates of nonfatal firearm injuries are estimates based on data collected from a stratified probability sample of 66 US hospitals that participate in the National Electronic Injury Surveillance System–All Injury Program (NEISS-AIP). Although rates of nonfatal firearm injuries appear to have increased from 2002 to 2011, the uncertainty in the estimates precludes definitive conclusions. Improvements in the delivery of trauma care may have contributed to a stable injury fatality rate over the decade; however, this is an open question requiring further study.


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November 25, 2013
Anupam B. Jena, MD, PhD; Eric C. Sun, MD, PhD; Vinay Prasad, MD
1Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
2Department of Anesthesia, Stanford University Hospitals, Stanford, California
3Medical Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
JAMA Intern Med. 2013;173(21):2011. doi:10.1001/jamainternmed.2013.9958.
November 25, 2013
Christian Westphal, Dipl-Vw
1Department of Statistics, University of Marburg, Marburg, Germany
JAMA Intern Med. 2013;173(21):2011. doi:10.1001/jamainternmed.2013.9961.
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