eLetters is an online forum for ongoing peer review. To submit an eLetter please go to the article you wish to respond to and click on the link that reads "eLetters: Submit a Response." Submission of eLetters are open to all health care professionals and experts in related fields.

eLetters to:

ELECTRONIC ARTICLE:
Anu McDonald, Maria Scranton, Robert Gillespie, Vandana Mahajan, and George A. Edwards
Voiding Cystourethrograms and Urinary Tract Infections: How Long to Wait?
Pediatrics 2000; 105: e50 [Abstract] [Full text] [PDF]
*eLetters: Submit a response to this article

eLetters published:

[Read eLetters] Apples and Oranges
Dmitri de la Cruz   (9 April 2000)

Apples and Oranges 9 April 2000
Top
Dmitri de la Cruz,
pediatrician
community clinic

Send letter to journal:
Re: Apples and Oranges

mrdelacruz{at}yahoo.com Dmitri de la Cruz

The fact that a delay in obtaining a VCUG has a significant no-show rate is striking and very important. However, to draw conclusions about the accuracy of a VCUG in detecting reflux as a function of time would be better answered in looking at VCUG's as a function of time itself. So if we want to answer the question of whether or not there is more reflux right after a UTI versus less reflux several weeks after the UTI we might want to see if there is a cause and effect relationship.Sadly, the pain and expense of the procedure makes this a difficult option. Another way of trying to answer the question would be run a well-performed randomized clinical trial. Unfortunately, as exemplified in this study, there may be a no-show rate problem. The no-show group needs to be examined closely as cause for bias.Unexamined, it may cause a serious flaw in the study's conclusions. We may also want to include children who are not hospitalized and have simple recurrent UTI's. These make up a larger number of cases than hospitalized children.