Objective: To collect data on incidents of potential or actual harm to general practice patients and to evaluate the possible causes of these incidents. Design: An observational study of incidents of potential harm based on a modified critical incidents technique. A non‐random sample of general practitioners (GPs) anonymously submitted incident reports contemporaneously. Setting and participants: Australian general practices between October 1993 and June 1995. During the study period, 324 GPs participated at some time. Main outcome measures: GP‐reported free‐text descriptions of incidents and structured responses for preventability, potential for harm, immediate consequences, predicted long‐term outcomes, type of incident, contributing factors, mitigating factors, and additional resource use. Results: 805 incidents were reported −76% were preventable; 27% had potential for severe harm. No long term harm was predicted for 66% of incidents. Incidents could relate to pharmacological management (51 per 100 incidents), non­ pharmacological management (42 per 100 incidents), diagnosis (34 per 100 incidents) or equipment (5 per 100 incidents). The most common contributory factors were poor communication between patients and healthcare professionals and actions of others (23 per 100 incidents each) and errors in judgement (22 per 100 incidents). Conclusion: Human errors and preventable system problems were identified. The incident monitoring technique provided useful data which could be applied to incident prevention strategies.

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The first 500 reports were analysed using both of qualitative and quantitative methods and a brief overview of results is presented. The methodological issues arising in the application of this technique to such a large, widely spread profession, in which episodes of care are not necessarily confined to a single consultation, are discussed. This study demonstrated that the incident monitoring technique can be successfully applied in general practice and that the resulting information can facilitate the identification of common factors contributing to such events and allow the development of preventive interventions.

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The included study found that people who took garlic every day for three months (instead of a placebo) had fewer colds. That is, over the three-month period, there were 24 occurrences of the common cold in the garlic group, compared to 65 in the placebo group. When participants experienced a cold, the length of illness was similar in both groups (4.63 versus 5.63 days). Quality of the evidence More participants in the garlic group (four) than the placebo group (one) noted a smell when burping, so it is possible that blinding of participants was not adequate. However, other potential biases were well controlled. The only included study is directly relevant to the review question. Although the trial is small, there were enough participants to provide precise, reliable results. There is no evidence that results were selectively reported. However, this was possible as the outcomes do not appear to have been decided in advance. Considering the financial incentive for supplement companies to produce positive trials, it is also possible that trials that showed no e ect of garlic were never published. Overall, the quality of the evidence is moderate. Side e ects Possible side e ects in this small trial included odour and a skin rash. More information is needed about the possible side e ects of garlic.