Tacrine and nursing home placement
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Reply from the Authors: Thal and colleagues offer several criticisms involving methodological issues, including the obvious critique of observational cohort studies that the results are those of a "healthy patient" effect "since it is plausible, logical, and likely that generally healthier patients will tolerate higher doses of tacrine." As we emphasized in the report, caution should be taken in the interpretation of any post hoc analysis or observational study. We disagree, however, with the criticisms offered by Thal and colleagues.
The number of nursing home placements (NHPs) and mortality events was small during the 30-week randomized portion of our study,1 but that fact does not preclude analysis. More importantly, the difference in both the number of events and their times was substantially large enough between the groups such that the odds ratio (OR) was statistically significant(p < 0.05). At their request were now report the treatment effect sizes for the 80- and 120-mg/d doses (table). Although …
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