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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

We read with interest the article titled "Occurrence, Causes, and Outcome of Delirium in Patients With Advanced Cancer"¹ in the March issue of the ARCHIVES. The statistical methodology is unclear to us, and we have noted some apparent errors. We are also concerned about the clinical research and ethical implications of the study as we understand it.

Questions Concerning the Data

Lawlor et al¹ used ² and t tests to make comparisons on a per-episode as opposed to a per-patient basis. This assumes delirium episodes are independent. It is questionable whether repeated episodes of delirium are truly independent events rather than an evolving terminal state (as supported by the 50% mortality rate in the palliative care unit). The data in Tables 3 and 4 of the article seem to indicate that the metabolic, nonrespiratory, infectious, and hematological factors have a 1:1 correspondence, but the numbers in the 2 tables do not match. The psychoactive drug . . . [Full Text of this Article]

Questions Concerning the Purpose and Conclusions of the Study

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RELATED LETTER

Clinical Research Requires IRB Review
Maureen Brady Moran
Arch Intern Med. 2001;161(17):2151.
EXTRACT | FULL TEXT  

RELATED ARTICLES

Occurrence, Causes, and Outcome of Delirium in Patients With Advanced Cancer: A Prospective Study
Peter G. Lawlor, Bruno Gagnon, Isabelle L. Mancini, Jose L. Pereira, John Hanson, Maria E. Suarez-Almazor, and Eduardo D. Bruera
Arch Intern Med. 2000;160(6):786-794.
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Delirium: The Occurrence and Persistence of Symptoms Among Elderly Hospitalized Patients
Sue E. Levkoff, Denis A. Evans, Benjamin Liptzin, Paul D. Cleary, Lewis A. Lipsitz, Terrie T. Wetle, Catherine H. Reilly, David M. Pilgrim, Joshua Schor, and John Rowe
Arch Intern Med. 1992;152(2):334-340.
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Reversibility of delirium in terminally ill patients and predictors of mortality
Leonard et al.
Palliat Med 2008;22:848-854.
ABSTRACT  

Clinical Research Requires IRB Review
Moran
Arch Intern Med 2001;161:2151-2151.
FULL TEXT