The Institute of Medicines

Due to bleeding risk, individuals on anticoagulant therapy or individuals who are vitamin K-deficient should not take vitamin E supplementation without close medical supervision. Absent of that, vitamin E is a well-tolerated relatively non-toxic nutrient. A tolerable upper intake level of 1,000 mg daily of a-tocopherol of any form (equivalent to 1,500 IU of RRR a-tocopherol or 1,100 IU of all-rac-a-tocopherol) would be, according to the Food and Nutrition Board of the Institute of Medicine, the highest dose unlikely to result in haemorrhage in almost all adults. 

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The Institute of Medicine was established in 1970 by the National Academy of Sciences to secure the services of eminent members of appropriate professions in the examination of policy matters pertaining to the health of the public. The Institute acts under the responsibility given to the National Academy of Sciences by its congressional charter to be an adviser to the federal government and, upon its own initiative, to identify issues of medical care, research, and education. Dr. Harvey V. Fineberg is president of the Institute of Medicine. 

Policy makers, practitioners, and scholars from a variety of disciplines have recently embraced a new approach to risk reduction in health care—a "systems approach"—without proposing any specific reforms of medical liability law. The Institute of Medicine (IOM) placed its imprimatur on this approach in its recent reports (Kohn et al., 2000 IOM, 2001). In its simplest form, a systems approach to risk reduction in health care posits that an injury to a patient is often the manifestation of a latent error in the system of providing care. In other words, a medical mishap is the proverbial "accident waiting to happen" because the injury-preventing tools currently deployed, including medical liability law, are aimed at finding the individuals at fault rather than the systemic causes of error. Coexistence of a systems approach to error reduction and medical liability law as a conceptual framework for policy makers implies that the latter is likely to evolve in an incremental fashion as the former makes more visible different aspects of the medical error problem. 

In 1999, the Institute of Medicine (IOM) estimate that 48,000-98,000 Americans die each year in the hospital because of mistakes and oversights in medical care ... 

In response to continued concerns about vaccine safety, the National Childhood Vaccine Injury (NCVI) Act of 1986 established a no-fault compensation process for people injured by them. The NCVI also mandated that the Institute of Medicine (lOM) reviews scientific evidence of vaccine-related ADRs in children. In 1996, the Department of Health and Human Services (HHS) made changes to the NCVI, which lessened its usefulness. In response to the problems this generated, the Vaccine Injured Children s Compensation Act of 2001 was introduced in Congress.This bill, however, also has its problems, and in April 2001, the bill was referred to the House subcommittee on health, where it still... 

The figure comes from a series of reports issued by the Institute of Medicine over the past decade. The experts who authored these reports revisited the question of recommended daily allowances and other measures of nutrient adequacy, and made recommendations regarding macronutrients (proteins, carbohydrates, fats and oils) and for micronutrients (vitamins and minerals). The Institute has had a long history of developing recommended intake levels, but in the recent... 

In addition to RDIs and RDAs, there is a set of values termed the dietary reference intakes (DRIs). These are the most recent set of dietary recommendations established by the Food and Nutrition Board of the Institute of Medicine, 1997-2001. DRIs vary significantly from the current RDIs and may provide the basis for updating the RDIs in the future (see www.nal.usda.gOv/fnic/etext/000105.html). 

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