eLetters

193 e-Letters

published between 2001 and 2004

  • Bonferroni correction for multiple comparisons
    Shyr-Chyr Chen

    Dear Editor

    We read with great interest the paper by Chen et al [1]. However, we believe there is a serious methodological error in the interpretation of the results.

    They did not apply Bonferroni correction when they made multiple comparisons between two groups. The Bonferroni correction is a statistical adjustment for the multiple comparisons [2,3]. The alpha level used in the study was 0.05 and they m...

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  • What about variation in speed between physicians?
    Sam G Campbell

    Dear Editor

    The letter by Gilligan and colleagues suggests that SHO's in emergency departments are getting slower, seeing far fewer patients in a standard full shift rota than in previous years. Using 'before-after' comparisons can be confounded by factors such as increased patient acuity, or increased availability of slower tests. Decreased access to actually seeing patients, because ED beds are 'blocked' by admi...

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  • Re: Authors' response
    Peter McQuillan

    Dear Editor

    We must accept that our original analysis, which assumed statistical independence between observations obtained from staff within the same hospital, might not be justified. To explore this possibility we have computed Intra Cluster Correlation Coefficients (ICCs) using estimated components of variance obtained from an analysis of variance in which hospitals were treated as random effects within a nest...

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  • Reply to letters
    Pinchas Halpern

    Dear Editor

    We thank Dr Menon for his thoughtful understanding of our solution to the development of EM in our country. We find it interesting that he believes that the system we developed out of necessity is potentially applicable to the UK and other countries with similar models.

    We would like to thank Dr Gaber for his insightful questions, and will attempt to answer them one by one.

    First we...

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  • Re: Ice, Pins and Sugar: Are they meant for reducing paraphimosis
    Stewart Teece

    Dear Editor

    In response to the letter from Dr Raveenthiran, I feel that there are a number of issues to be addressed. Firstly, many BETs are written not to reflect and reinforce current practice in emergency departments. Often, as in this case, this is a response to advice recieved upon referring to the appropriate specialty. Many techniques require questioning whether they are acccepted practice or otherwise. As...

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  • Re: Regurgitation of Best Evidence?
    Stewart Teece

    Dear Editor

    I would like to thank Drs Glazebrook and Probst for pointing out a potential source of confusion. I also considered gastric lavage innapropriate management of overdose for multiple reasons, which gave me cause to review the evidence. The fact it's use is still occasionally suggested in clinical practice remains a personal concern.

    At the time of the initial authorship of the BET concerned, g...

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  • ED RSI in the UK - the growing evidence base is not inconsistent
    Cliff Reid

    Dear Editor

    We would like to thank Dr Oglesby and colleagues for their helpful comments [1], and for highlighting their data on complication rates for ED RSI [2] which were published subsequent to the submission of our paper [3].

    We share entirely their reservations regarding propofol as an induction agent in ED patients. It is our observation that it is associated with a greater incidence of hypotens...

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  • Ice, Pins and Sugar: Are they meant for reducing paraphimosis
    Raveenthiran Venkatachalam

    Dear Editor,

    I read, with interest, the article by Jones and Teece [1]. The authors have attempted to find the best out of three procedures, which more or less resemble home remedy. They should not be offered in a modern scientific emergency department because they are based on misunderstood pathophysiology of paraphimosis [2].

    In paraphimosis, as soon as the constricting ring of prepuce gets stuck...

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  • Head injury transfers
    Peter J Hutchinson

    Dear Editor

    The letter by C D Okereke [1] “Head injury transfers: arm of greatest delay” confirms that considerable delays persist in the transfer of patients with traumatic brain injury from district general hospitals to regional neurosurgical units. Our own data indicates that emergency craniotomy for traumatic brain injury was achieved in only 1 out of 24 patients [2] within the recommended four hour target [...

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  • Regurgitation of Best Evidence?
    William Glazebrook

    Dear Editor

    While I normally find the Best BETs both informative and useful, I was surprised at the publishing of one concerning gastric lavage in drug overdose [1].

    Gastric lavage is both dangerous and without benefit in all but a few overdoses. The 1997 Joint Position Statement made by the American Academy of Clinical Toxicology, and the European Association of Poisons Centres stated that gastric lavage s...

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