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I read with great interest the article entitled “Uncovering Histologic Criteria With Prognostic Significance in Toxic Epidermal Necrolysis” wherein the authors suggest that “the degree of inflammation predicts the clinical outcome approximately. . . . ”1 Strangely, 2 different statistical tests were performed to show ultimately that histologic grade was associated with survival. Rather than directly comparing the histologic grade with survival, the authors employed the transitive property and first showed that histologic grade was associated with total body surface area sloughing and then they showed that total body surface area sloughing was associated with survival. Thus, by the transitive property, they suggest that since A was associated with B and B with C, then A must be associated with C. This is not necessarily true.
Using the data presented in their own Table 1, I performed the natural statistical test. I employed a 3×2 Fisher exact test to test for the association directly between histologic grade and survival. Perhaps this test was not reported in the article because the P value of this analysis was not significant (P = .11).
Histologic grade may be associated with survival, but this study did not show this directly and the problem may be that the numbers of subjects involved did not provide enough power to detect the difference among these 3 grades.
Correspondence: Dr Adams, Department of Dermatology, University of Cincinnati, PO Box 670592, Cincinnati, OH 45267-0592 (adamsbb@email.uc.edu).
Financial Disclosure: None.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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