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The review article by Chapman et al1 has provoked a vigorous correspondence,2–5 amongst other things calling on Thorax to ‘respond appropriately’ and even withdraw the manuscript. We inherited the manuscript from our predecessors and played no part in its commissioning or review. However, we are quite clear that the appropriate response is not to withdraw the manuscript, but rather to allow a vigorous debate in the correspondence columns. Withdrawal of the manuscript would only be the response if there was clear evidence of duplicate publication, data fabrication or some other piece of flagrant dishonesty, which is not the case. In this manuscript, the final conclusion is that we do not have enough evidence to determine whether a reactive asthma strategy such as SMART is preferable to a chronic suppressive study. This is undoubtedly true. Perhaps we will ultimately conclude that this question cannot be answered definitively and we should accept that there is more than one effective way to approach the goals of asthma control and risk reduction. Many would argue that this is a good thing as our patients have different expectations and concerns about chronic drug treatment for asthma.
We welcome debate about the article, and we will consider other relevant letters and articles if submitted, inviting the authors to respond. We are grateful to the reviewers, who do a fine job, but it is the authors who are responsible for the manuscript. Above all, we need to work together to design robust clinical trials with appropriate and relevant end points to answer the great questions about asthma treatment. Sound and fury, no matter what the source, is no substitute for primary data.
Competing interests None.
Provenance and peer review Not commissioned; not externally peer reviewed.
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