394 e-Letters

published between 2012 and 2015

  • Questions about Comorbidities
    Julian F. Guest

    There was never any intention to match the wound patients with their matched controls on the basis of their comorbidities, since differences in comorbidities between the groups is an outcome we wanted to measure. The patients' records did not describe the severity of their comorbidities in all cases. Furthermore, it would have been difficult to disentangle resource use for the comorbidities from that associated with wound...

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  • Cardiovascular mortality 1990 to 2006
    Rodney P Jones

    I note with interest that your population cohort covers a 16 year time period.

    In this respect may I direct you to some research I have been conducting on a time-series of infectious like outbreaks affecting both medical admissions and all-cause mortality (1-17).

    I have recently demonstrated these events across the whole of Europe (10) and Australia (14), they are condition specific (1,3-9,11,13), and...

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  • Response to Miller et al on clinical trial transparency
    Bryan R Deane

    The article by Miller et al. published on 12th November (1) took a similar approach to previous studies by Rawal and Deane (2, 3) that also set out to examine the clinical trial evidence related to recently approved medicines. The article therefore requires some qualification; while the study examines some of the industry-sponsored clinical trials related to 15 selected new medicines approved by the FDA in 2012, their st...

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  • Questions about Comorbidities
    Marissa J. Carter

    Guest et al are to be congratulated on a well-conducted study providing further insight into the economic burden of chronic wounds in the UK.

    I assume that random sampling was chosen because of the considerable work required just to assess the economic resources used in the 1,000 patients sampled in each group. The authors then chose to employ sensitivity analysis in regard to the number of comorbidities rather...

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  • Re:The effect of statins on average survival - revisited
    Jesper Hallas

    We can hardly disagree about the limitations pointed out by Dr Chang et al and by Roger Marshall. We emphasized in the discussion section that the postponements (or increment in restricted mean survival) calculated by us were restricted to the trials' running time, usually in the order of 5 years. We fully agree - and have emphasized in our paper - that they do not answer the question on what would be the benefit from a l...

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  • Re: Miller J et al, November 12th Publication
    Norbert W Bischofberger

    In the November 12th issue the BMJ published a paper (Miller, J., et al) on "Clinical Trial Registration, Reporting, Publication and Food and Drug Administration Amendments Act (FDAAA) Compliance of Drugs Approved by FDA in 2012".

    In the paper the authors conclude that for Stribild, a drug for the treatment of HIV infection developed and marketed by Gilead Sciences, Inc., only 9% of clinical trials submitted to...

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  • Transparency grade reflects only one aspect of transparency
    Erick H. Turner

    Imagine a drug company conducting 10 trials, 5 of which turn out positive and 5 negative. The 5 positive trials are, unsurprisingly, published. The 5 negative trials are subjected to outcome reporting bias, aka statistical alchemy and HARKing (hypothesizing after the results are known), so that they appear to be positive in the final publications. The downstream reader (or even systematic reviewer) is misled into believi...

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  • Separated cycling routes on cyclist safety
    Ediriweera Desapriya

    Globally, there is a strong movement to encourage active lifestyles in our communities. Clinicians, the public health community and policy makers around the globe are encouraging communities to engage in active lifestyles. Dr.Vivek Murthy, the US Surgeon General, is convinced of the benefits of active lifestyles in our communities and he encourages communities to embrace healthy behaviors (1). Furthermore, the Surgeon...

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  • The effect of statins on average survival - revisited
    Shu-Ching Chang

    The recent paper by Kristensen et al. [1] examined 11 randomized clinical trials (RCTs) of statins and concluded that they provide "a surprisingly small average gain in overall survival within the trials' running time", and that "The median postponement of death for primary and secondary prevention trials were 3.2 and 4.1 days, respectively."

    This appears to question the value of statins, yet the information a...

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  • Euthanasia for psychiatric patients: ethical and legal concerns about the Belgian practice
    Stephan Claes

    As Belgian professionals in mental health care and medical ethics, we felt the need to comments on the paper published in BMJ Open by Thienpont et al., entitled "Euthanasia requests, procedures and outcomes for 100 Belgian patients suffering from psychiatric disorders: a retrospective, descriptive study" (Thienpont et al., BMJ Open. 2015 Jul 7;5(7):e007454.) We argue that this study denies several important and unresolved iss...

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