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March NaN, 2000

Tube Feeding in Patients With Advanced Dementia—Reply

Author Affiliations

Phil B.FontanarosaMD, Deputy EditorIndividualAuthorStephen J.LurieMD, PhD, Fishbein FellowIndividualAuthor

JAMA. 2000;283(12):1563-1564. doi:10.1001/jama.283.12.1563

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.

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