eLetters

248 e-Letters

  • Homeopathy and childhood asthma
    Robert Leckridge

    Dear Editor

    This study of quality of life in children with asthma treated with homeopathy is fatally flawed.[1] The Childhood Asthma Quality of Life instrument used was validated in a study by French et al.[2] The children entered into White’s study had scores consistent with those of normal children who don’t have asthma. For a statistically significant improvement to occur in this score, the treated group wo...

    Show More
  • Salbutamol vs aminophylline in severe asthma in children
    Florens GA Versteegh

    Dear Editor

    It is indeed a pity that there was no comparison between continuous aminophylline and continuous salbutamol. The authors did not make it very clear why they did not choose this option. The conclusion that there is some favourable outcome with aminophylline is therefore, in my opinion, too strong for the data they present. Another query is: Why did the authors use aminophylline, instead of theofylline, wit...

    Show More
  • Author's Reply
    Bernard G Higgins

    Dear Editor

    We thank Dr Chanarin for his interest in the new Asthma Guideline. We will answer the points made in the order in which he raises them.

    1. The quoted studies on breast-feeding appear to be equivocal in terms of the protective effect on asthma, but both show protection against wheezing illness in the first years of life. The recommendation in the guideline specifies such wheezing illne...

    Show More
  • Acidification of Exhaled Condensates in Cystic Fibrosis
    Richard M. Effros

    Dear Editor

    I read with interest the article of Tate et al. indicating that exhaled condensates are acidic in patients with CF and become more acidic during exacerbations. The data show differences in mean values (with some overlap) and the hypothesis that the airways are acidic in these patients seems plausible. However I am concerned that the condensate measurements cannot give a reliable estimate of airway...

    Show More
  • BTS and SIGN asthma guidelines
    Nicholas Chanarin

    Dear Editor

    The New Guidelines use evidence based methodology extensively. This methodology has been developed by the Scottish Intercollegiate Guidelines Network and is not only well respected but has been widely applied to develop other guidelines. The guidelines use levels of evidence, I quote
    “Level A is: At least one meta analysis, systematic review, or RCT rated as 1++ and directly applicab...

    Show More
  • Author's reply
    Bart P Thoonen

    Dear Editor

    In their response to our article Dr Griffiths makes some important remarks, which we would like to comment on.

    We did indeed take clustering into account in the analysis of our data. As stated in the methods section of our paper we used multilevel models.[1] In this multilevel model practices were included as the level of clustering in these models.

    A second methodological questio...

    Show More
  • Author's reply to Dr Martin Olmedo
    Bart P Thoonen

    Dear Editor

    In a reaction to our paper Dr Martin Olmedo asks what factors may explain the observed better control of illness in our self-management group.

    The self-management program in our study consisted of education, skills training and written instructions for autonomous adaptation of maintenance therapy with inhaled corticosteroids. As this intervention consisted of more than one element, it is n...

    Show More
  • Buteyko
    Alexandra Hough

    Dear Editor

    Thank you for a well-reasoned explanation on the effect of yoga on asthma.

    The study quoted [1] which justifies the Buteyko technique was flawed by:
    * unequal groups in that the Buteyko group initially required 1½ times the steroids of the control group
    * the Buteyko group receiving seven times the follow-up phone calls as the control group, plus extra breathin...

    Show More
  • Re: Self-management of asthma in general practice, asthma control and quality of life
    Pablo J Martin Olmedo

    Dear Editor

    I would like to ask the authors a question:

    In the results we can observe that the control of illness is better in the SM group but you say also that there were a saving in inhaled corticosteroids.... so how can you explain the best control? May be the environmental control or there are others explanations?

  • Self management of asthma in primary care
    Chris Griffiths

    Dear Editor

    Evidence that self management programmes for asthma are effective in primary care is elusive.[1] Thoonen and colleagues have carried out a complex and impressive cluster randomised trial from which they conclude that a self management programme implemented in Dutch general practices lowers the burden of illness.[2] Parts of their analysis require comment.

    It is not clear whether clustering has bee...

    Show More

Pages