Predicting the Outcome From Hypoxic-Ischemic Coma-Reply

David E. Levy, MD; Fred Plum, MD; John C. Caronna, MD; Robert H. Lapinski, PhD
JAMA. 1986;255(12):1570-1571. doi:10.1001/jama.1986.03370120043012.
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In Reply.—  Drs Jørgensen and Rosenberg have raised a number of questions about application of our prediction algorithms to recovery from nontraumatic coma.1The letter cites Dr Black's2 reservations about the usefulness of predictive techniques derived from retrospective data but does not state, as Dr Black did, that we recognized that limitation and proposed that the techniques be tested prospectively. Our data were, as noted, collected prospectively; the analysis was performed later, after the best functional outcome had been determined. Jørgensen and his colleagues similarly collected data on patients after cardiac arrest3,4 and, like us, analyzed the data subsequently. This is the only way hypotheses for subsequent testing can be derived.They comment on the possibility of high interobserver variability in our study because data from several centers were involved. Our study was designed to minimize this possibility by relying on strictly defined definitions of all clinical


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