Sergio de A. Nishioka, MD, MSc
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Nishioka S.; Visceral Leishmaniasis in Southern Sudan. Ann Intern Med. 1997;126:332. doi: 10.7326/0003-4819-126-4-199702150-00018
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Published: Ann Intern Med. 1997;126(4):332.
TO THE EDITOR:
Seaman and colleagues  recently found that increasing age, long duration of illness, decreasing hemoglobin level, and decreasing body mass index were independently associated with death from (or with) visceral leishmaniasis in adults in Sudan. The large sample size in their study makes it unlikely that random error had any effect on the risk ratio estimates, but measurement errors resulting from the limited resources that were available to the investigators may have affected the validity of the results. Age was particularly likely to be systematically overestimated in patients whose disease was more severe and had lasted longer (and who therefore were at higher risk for death) because patients with severe malnutrition tend to look older than they really are. If this differential misclassification bias occurred, the effect of age as a predictor of death was overestimated.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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