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Archived Comments for: Asthma is a risk factor for acute chest syndrome and cerebral vascular accidents in children with sickle cell disease

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  1. Please provide data as proportion of patients

    Brian Alper, Editor-in-Chief, www.DynamicMedical.com

    23 January 2005

    I manage an evidence-based medical reference and update information when clinically relevant articles are published that represent the best available evidence for a concept.

    Your article appears to be clinically relevant, and clinicians caring for children with sickle cell disease should be aware of these findings. However, some additional information would be more useful to put this in perspective.

    Table 2 currently compares the total number of events among the 48 children with asthma and 48 children without asthma. Significant differences were found for the numbers of acute chest syndrome episodes, strokes and blood transfusions.

    Results were reported only as numbers of events and not numbers of patients with events, so it is possible that 1 or 2 patients with asthma had a large number of events and there is not any association between asthma and these events in the patients overall.

    Could you please report the number of patients in each group who had any acute chest pain episodes, the number who had any strokes, and the number who had any transfusions? If the number is very high for any of these results (e.g. 47 patients in each group having any transfusions), then please report the number of patients having more than a threshold number of events (e.g. the number of patients having more than 10 transfusions in a 5-year period).

    Reporting the data in this way will help us better understand the potential impact on individual patients.

    Please also e-mail me at editor@dynamicmedical.com and I will update the summary of your article which is currently found in the Prognosis section of the sickle cell anemia summary and reads as follows:

    comorbid diagnosis of asthma may be associated with increased rate of acute chest syndrome episodes, strokes and blood transfusions; 5-year retrospective study comparing 48 children (median age 10 years) with sickle cell disease and asthma with 48 matched children with sickle cell disease and no asthma; overall, there were 90 vs. 58 admissions for acute chest syndrome (p = 0.03), 10 vs. 2 strokes (p = 0.05), and 432 vs. 226 blood transfusiosn (p = 0.01) (Clinical and Molecular Allergy 2005 Jan 21;3:2); results were reported only as numbers of events and not numbers of patients with events, so it is possible that 1 or 2 patients with asthma had a large number of events and there is not any association between asthma and these events in patients overall (DynaMed commentary)

    Thank you.

    Brian S. Alper, MD, MSPH

    Editor-in-Chief, DynaMed

    Columbia, MO, USA

    Competing interests

    I have no competing interests related to asthma or sickle cell disease. As the editor of DynaMed, I would like to clarify information that would make this article more useful for a clinical reference.

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