In an article referring to a study published in the New England Journal of Medicine (2009;360:2079-89) that looked at the effect of combination therapy versus monotherapy in the treatment of bronchiolitis, the ACEP News article “Combo Regimen Slashed Bronchiolitis Burden” (July 2009, p. 6) failed to mention that, when adjusted for multiple comparisons, the study results failed to meet statistical significance. From the PubMed abstract: “In the unadjusted analysis, only the infants in the epinephrine-dexamethasone group were significantly less likely than those in the placebo group to be admitted by day 7 (relative risk, 0.65; 95% confidence interval, 0.45-0.95, P = .02). However, with adjustment for multiple comparisons, this result was rendered insignificant (P = .07).”

Unless readers also are familiar with the New England Journal of Medicine article, they would be misled into believing that combination therapy provided a statistically significant benefit (it did not, at least not in this study).

Michael J. Verive, M.D.

Evansville, Ind.

Editor’s reply: Our summary of the study in question included some of the caveats listed by the authors, but it is true that the fact mentioned by Dr. Verive was omitted. Mea culpa.