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Dear Editor,

This publication[1] is confusing to parents and physicians because it draws far reaching conclusions from unconvincing data.

METHODOLOGICAL PROBLEMS
In our opinion, the validity of this analysis is threatened by selection bias, imputation bias and presentation bias. We think that the conclusions drawn from this study are not generalizable and that many current issues pertaining to SIDS epidemiology have not been adequately addressed.

  • Old data sets
  • Problematic selection of control groups and adjustment
  • Problematic imputation
  • Important exposures missing
  • No information on intended versus non-intended bed-sharing

 

POTENTIAL MISCLASSIFICATION BIAS

  • Problematic definition of breastfed cases
  • Possible lack of identification of non-caregivers

INADEQUATE DISCUSSION OF ISSUES RELATED TO RISK


INTERPRETATION OF BED SHARING

  • Bed-sharing as a lifestyle choice

 

SUMMARY: A MISSED OPPORTUNITY

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