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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]
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[Read P3R] Apples and Oranges
Dmitri de la Cruz   (9 April 2000)

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

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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.