Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor
In Reply: We believe that for invasive and
burdensome interventions such as tube feeding, the first question is whether
there is evidence of benefit. Our review, which reported no evidence of benefit
from tube feeding, could be seen as an extended form of literature search;
we have received many responses, but none that offer any study suggesting
any benefit for any of the putative indications. With no evidence of benefit,
we believe this intervention should be used with extreme caution and reluctance.
Dr Portnoi and Dr Robinson emphasize the lack of randomized clinical trials
to prove that tube feeding is ineffective. For us, this is a secondary issue.
Finucane TE, Christmas C. Tube Feeding in Patients With Advanced Dementia—Reply. JAMA. 2000;283(12):1563-1564. doi:10.1001/jama.283.12.1563