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What Constitutes an Adequate Evaluation of Device-Guided Breathing?—Reply

What Constitutes an Adequate Evaluation of Device-Guided Breathing?—Reply Letters last year of life, with the exception of those experiencing sud- Randomization also appears to have been unsuccessful, den vascular death, continuing therapy with preventive drugs since participants assigned to the active intervention had sig- such as statins is unlikely to be of clinical benefit. In con- nificantly worse glycemic control at baseline compared with trast, treatment with statins may lead to significant harms in- controls. This may indicate underlying differences in disease cluding cognitive impairment or muscle weakness. Our own severity, ability to use therapeutic interventions effectively, ad- research has demonstrated that more than 30% of patients with herence to treatment, or all of these factors and has impor- cancer were dispensed a statin in the month prior to death. tant implications for both the participants’ ability to respond Moreover, polypharmacy associated with multimorbidity is to the experimental treatment and their susceptibility to ad- likely to result in cumulative adverse drug effects, which can be verse events. minimizedbycarefulclinicalreviewofthepatient’sprioritiesand This study also raises important questions about what con- pharmacological profile of the patient’s drug therapies. For ex- stitutes an appropriate comparator for evaluation of a guided- ample, if the primary therapeutic aim is analgesia, and this breathing intervention. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

What Constitutes an Adequate Evaluation of Device-Guided Breathing?—Reply

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References (5)

Publisher
American Medical Association
Copyright
Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/jamainternmed.2013.13790
pmid
24711183
Publisher site
See Article on Publisher Site

Abstract

Letters last year of life, with the exception of those experiencing sud- Randomization also appears to have been unsuccessful, den vascular death, continuing therapy with preventive drugs since participants assigned to the active intervention had sig- such as statins is unlikely to be of clinical benefit. In con- nificantly worse glycemic control at baseline compared with trast, treatment with statins may lead to significant harms in- controls. This may indicate underlying differences in disease cluding cognitive impairment or muscle weakness. Our own severity, ability to use therapeutic interventions effectively, ad- research has demonstrated that more than 30% of patients with herence to treatment, or all of these factors and has impor- cancer were dispensed a statin in the month prior to death. tant implications for both the participants’ ability to respond Moreover, polypharmacy associated with multimorbidity is to the experimental treatment and their susceptibility to ad- likely to result in cumulative adverse drug effects, which can be verse events. minimizedbycarefulclinicalreviewofthepatient’sprioritiesand This study also raises important questions about what con- pharmacological profile of the patient’s drug therapies. For ex- stitutes an appropriate comparator for evaluation of a guided- ample, if the primary therapeutic aim is analgesia, and this breathing intervention.

Journal

JAMA Internal Medicine – American Medical Association

Published: Apr 1, 2014

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