JAMES OAT JUDGE, M.D.
To the editor: I was disappointed in the insufficient editorial review of the article by Nesto and colleagues (1) on whether asymptomatic cardiac ischemia is more likely to occur in diabetic patients. The study appears to be a retrospective analysis of 100 positive exercise thallium tests done for various reasons. However, the article implies that the patients were selected because of a positive exercise thallium test and were then studied using a symptom-limited exercise test.
For such a retrospective study, the findings should have been noted and qualified, with the suggestion to follow up with an appropriately designed prospective study.
JUDGE JO. Asymptomatic Cardiac Ischemia in Diabetic Persons. Ann Intern Med. ;108:903. doi: 10.7326/0003-4819-108-6-903_1
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Published: Ann Intern Med. 1988;108(6):903.
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