October 16, 1987

The Relation Between Vaginal Spermicides and Congenital Disorders

Author Affiliations

Boston University School of Medicine

Boston University School of Medicine

JAMA. 1987;258(15):2066. doi:10.1001/jama.1987.03400150058025

To the Editor.—  Recently, Bracken1 has added yet another compelling argument challenging the validity of the findings that suggest that spermicides cause selected birth defects. It remains to be pointed out, however, that Jick et al2 have evaded the central challenge raised by Dr Watkins' letter,3 namely, that without further evaluation of their findings they should not have published them at all: had they reclassified all "exposed" noncases as well as cases (as they suggested),2 they would very likely no longer have had adequate statistical power, and there would have been nothing to publish. In addition, Dr Watkins hinted in his letter3 and has explicitly testified in court4 that at least one of the investigators was made aware of the problem of misclassification of exposure status before the findings were submitted for publication. The authors now have the choice either to take the step