Reply to Walker et al.
Reply to Walker et al.
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回复沃克等人。
DOI：
10.1093/cid/cit099
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发表时间：
2013
期刊：
影响因子：
--
通讯作者：
Aronoff,DavidM
中科院分区：
文献类型：
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作者：
Walk,SethT;Micic,Dejan;Galecki,AndrzejT;Rogers,MaryAM;Washer,Laraine;Newton,DuaneW;Malani,PreetiN;Young,VincentB;Aronoff,DavidM
致编辑-我们感谢步行者等人对我们工作的兴趣[1]。我们的研究发现，当调整其他协变量时，感染核糖核酸型027/078菌株的患者与其他患者相比，艰难梭菌感染（CDI）的临床严重程度无差异[2]。对暴露（核糖体分型）和结局（严重程度）之间假设因果途径的因素（如白细胞计数）进行调整，已在其他地方进行了讨论[3]。删除白细胞计数作为协变量或将其纳入严重疾病的定义中并没有改变我们的发现[3]。我们理解对所得P值接近标准α水平这一事实的关注。05.我们使用了科学文献中发现的α的常规临界点，但认识到其局限性。然而，我们对整个数据集进行了二次分析（补充表1 [2]），共收集了413例CDI病例。核糖体027/078与严重疾病之间的关联在该分析中产生了1.34的优势比（95%置信区间，. 67-2.58），仅调整年龄，性别和CDI监测定义的因素之前存在的CDI诊断。
TO THE EDITOR—We thank Walker et al for their interest in our work [1]. Our study found no evidence of difference in clinical severity of Clostridium difficile infection (CDI) between patients infected with ribotype 027/078 strains compared with others, when adjusted for other covariates [2]. Adjustment for factors on the hypothesized causal pathway between exposure (ribotype) and outcome (severity), such as leukocyte count, has been addressed elsewhere [3]. Removing the leukocyte count as a covariate or including it in the definition of severe disease did not alter our findings [3]. We appreciate the concern regarding the fact that the resultant P values were close to the standard α level of. 05. We used the customary cut-point for α found in the scientific literature but appreciate its limitations. It is possible, with more patients, that an association may be found. However, a secondary analysis of our entire dataset (Supplementary Table 1 [2]) was conducted with a total of 413 CDI cases. The association between ribotype 027/078 and severe disease in this analysis yielded an odds ratio of 1.34 (95% confidence interval,. 67–2.58) when only adjusted for age, sex, and CDI surveillance definition—factors that existed prior to CDI diagnosis.