PEDIATRICS Vol. 90 No. 5 November 1992, pp. 780
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Presurgical Routine Screening

ALAN COHEN MD1 and CAROL BURK MD1

1 Division of Hematology, The Children's Hospital of Philadelphia, 34th Street and Civic Center Blvd, Philadelphia, Pennsylvania 19104

In Reply.—

Doctors Lackmann and Töllner provide additional data supporting our finding that the discovery of clinically important coagulation disorders during routine preoperative laboratory screening is infrequent. However, these investigators are troubled, as are we, by the problem of determining the appropriate use of screening tests when the disorder is rare and the tests are imperfect, but the consequence of failing to recognize the disorder may be grave. Even the most elaborate cost-benefit analysis may be of little comfort in approaching the individual patient and concerned parents.