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Art and Mind

Craig Zwerling, MD, PhD, MPH; Paul S. Whitten, MS; Charles S. Davis, PhD; Nancy L. Sprince, MD, MPH
JAMA. 1998;279(17):1348-1350. doi:10-1001/pubs.JAMA-ISSN-0098-7484-279-17-jbk0506.
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In Reply.—Our correspondents raise a number of issues concerning measurement and selection that are important for future research directions. However, we do not believe that these concerns undermine the results of our article.

Our main finding demonstrated a modest association between occupational injuries and preexisting work disabilities. Dr Seelman points out that we excluded 3728 cases and that "without this exclusion, the results are not statistically significant." We excluded these cases because they reported that both the onset of their disability and their occupational injury occurred within the last year. We were unable to determine whether the disability preceded the injury or was a consequence of it. We have now reanalyzed the data including an additional 2806 of the previously excluded cases (using a complex algorithm based on more detailed time categories to establish that the disability preceded the injury). The result showed that after adjusting for occupation, self-employment, and age, occupational injury was still associated with preceding work disability with an odds ratio (OR) of 1.35 (95% confidence interval [CI], 1.19-1.54), essentially the same as the OR of 1.36 (95% CI, 1.19-1.56) reported in our article.


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