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Diagnostic Delays With Bacterial Meningitis-Reply

Markku J. T. Kallio, MD; Terhi Kilpi, MD; Marja Anttila, MD; Heikki Peltola, MD
JAMA. 1995;273(8):622. doi:10.1001/jama.1995.03520320029035.
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In Reply.  —In our series of 325 children with bacterial meningitis, we found that a prior visit to a physician and thus a possible diagnostic delay did not result in a worse clinical condition on admission to hospital, in a poorer recovery during hospitalization, or an increase in the risk of death or persistent sequelae.Dr Wenner emphasizes that the number of patents in our study is inadequate for any conclusions. He states that we should not have less than 187 000 patients to be able to say whether or not a difference of 1% exists between groups.However, our study is not a randomized controlled trial but an observational study. The use of significance testing in observational studies can be and has been questioned.1 Although we apply statistical tests and give P values, our conclusion is cautious, not straightforward "acceptance of the null hypothesis."While our 325 patients

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