808 e-Letters

  • Hazards of hypnotics probably underestimated
    Daniel F. Kripke

    Daniel F. Kripke, M.D. and Robert D. Langer, M.D., M.P.H.

    This study provides additional evidence that use of hypnotics is significantly associated with future poor health and mortality. The analysis has the strength of evaluating the potentially-confounding roles of sleep duration and subjective insomnia and offers new information about several morbidities predicted by hypnotic use. The presentation gives con...

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  • Metformin is a safe medication in mild-to-moderate chronic kidney disease.
    David Arroyo

    Dear Editor,

    Ekstrom and colleagues publish a very interesting observational study comparing the rates of various outcomes depending on the type of antidiabetic drug prescribed.(1) This large population-based study presents some limitations, such as baseline difference between groups, attributing outcomes to initial treatment regardless of changes over time, or grouping diverse outcomes such as acidosis and infec...

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  • Data mapping for GPs
    Ditch Townsend

    We are not aware of any primary care trusts (PCTs) or emerging clinical commissioning groups (CCGs) who regularly provide a range of detailed data on health by lower level super-output area (LSOA). We became aware of this paper on 15th June 2012 having already begun to consider ways to map general practice (GP) Quality Outcomes Framework (QOF) data by LSOA. The paper's conclusions presented us with useful indicators of ef...

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  • Life expectancy record holders have about average life disparity levels at each life expectancy level
    Alyson A. van Raalte

    Alyson A. van Raalte, James W. Vaupel, Zhen Zhang

    Monden and Smits raise a valid point that "the countries that reached a certain e(0) first are not the most equal countries at that level of e(0)" [1]. We do not dispute this. In fact, we performed a similar analysis in the supporting material (Figure S4) [2]. At each e(0) level, our figure compared the life disparity level of e(0) leaders to the average life...

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  • Important errors in "Memantine and cholinesterase inhibitor combination therapy for Alzheimer's disease: a systematic review" by Farrimond et al.
    George T. Grossberg

    George T. Grossberg, MD, St. Louis University School of Medicine, St Louis, Missouri, USA

    Yvonne Wirth, MD, PhD, Wirth Consulting, Stuttgart, Germany

    Suzanne Hendrix, PhD, Pentara Corporation, Salt Lake City, Utah, USA

    Michael Tocco, PhD, Forest Research Institute, Jersey City, New Jersey, USA

    Stephen M. Graham, PhD, Forest Research Institute, Jersey City, New Jersey, USA


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  • Intervention rates should be interpreted in the context of perinatal morbidity, not just mortality
    Jeremy J Chin

    Dahlen's study, "Rates of obstetric intervention among low-risk women giving birth in private and public hospitals in NSW: a population-based descriptive study" provides a useful window into contemporary midwifery and obstetric practice in Australia. It is unfortunate that the authors choose to discuss the rising rate of intervention in low-risk women in both private and public settings in the context of a static perinata...

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  • Private Obstetrics - again
    Robert G Buist

    This paper by Dahlen et al has reignited the public debate about obstetric intervention rates in Australia. Strangely - given the size of the dataset available to the authors - adverse perinatal outcomes were not examined in the study. However in the discussion the authors assert "these (higher) rates do not appear to be parallel to or be associated with a better infant outcome" and go on to cite a small single centre RC...

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  • Conclusion on the impact of interventions is not supported by data in the paper
    Amy Tuteur, MD

    Dahlen et al. claim:

    "The continual rise in obstetric intervention for low-risk women in Australia is concerning in terms of morbidity for women and cost to the public purse. The fact that these procedures which were initially life- saving are now so commonplace and do not appear to be associated with improved perinatal death rates demands close review."

    However, the authors never looked at the perinata...

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  • Life expectancy record holders not most equal if compared within life expectancy levels
    Jeroen Smits

    Christiaan Monden, lecturer (1), Jeroen Smits, associate professor (2)

    1. University of Oxford, 2. Radboud University Nijmegen

    Vaupel, Zhang and Van Raalte (VZ&V) have made an interesting contribution to the study of variation in length of life (or life disparity as they call it) on the basis of life table data [1]. A fascinating aspect of this literature is that the inequality measures that are...

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  • Letter in response to Bhattachariya et al. August 2012
    Patrick Carroll

    Dear Sirs

    Re:Reproductive outcomes following abortion: A national register- based cohort study in Scotland. Bhattacharya S et al. BMJOpen August 2012

    The authors of this study do not acknowledge that some hundreds of Scottish resident women come to England each year for abortions. As a consequence they are underestimating the risk of premature births post abortion.

    The numbers are significa...

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