JAMES G. DOLAN, M.D.
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To the editor: I disagree with Levey and associates (1) that their decision analysis model has shown that "the choice between biopsy and empiric steroids for the average adult with idiopathic nephrotic syndrome is a toss-up." For this conclusion to be valid, the authors would have to show that their analysis is methodologically correct, that their results are insensitive to plausible changes in the event probabilities and utility measures used in the model, and that the model itself incorporates all considerations that influence the clinical decision-making process. Their study does not fully meet any of these criteria.
Although the authors
DOLAN JG. Idiopathic Nephrotic Syndrome and Renal Biopsy. Ann Intern Med. ;108:494. doi: 10.7326/0003-4819-108-3-494_1
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Published: Ann Intern Med. 1988;108(3):494.
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