SEYMOUR HERSCHBERG, M.D.
To the editor: Drs. Engel, Meister, and Frankl have implied in their article "The 'R-on-T' Phenomenon" (Ann Intern Med 88:221-225, 1978) that the R-on-T phenomenon may have little clinical significance in terms of mortality. Although this seems to be substantiated by their data, and is probably true, the interpretation depends on how one looks at the data.
On page 223 under the subheading "Epidemiology of R-on-T," the reported increment of death among the insured population is 33%, and the reported increment in patients with coronary heart disease is 50%. Although the numbers are themselves small, when looked at as an
HERSCHBERG S. R-on-T Phenomenon. Ann Intern Med. ;89:137–139. doi: 10.7326/0003-4819-89-1-137
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Published: Ann Intern Med. 1978;89(1):137-139.
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