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Clinical and Ethical Questions Concerning Delirium Study on Patients With Advanced Cancer
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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
RELATED LETTER
Clinical Research Requires IRB Review
Maureen Brady Moran
Arch Intern Med. 2001;161(17):2151.
EXTRACT
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RELATED ARTICLE
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.
ABSTRACT
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
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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
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