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Article
June 23, 1989

Incidence of Acute Mountain Sickness at Intermediate Altitudes-Reply

Author Affiliations

State University of New York School of Medicine Stony Brook

State University of New York School of Medicine Stony Brook

JAMA. 1989;261(24):3552. doi:10.1001/jama.1989.03420240065023
Abstract

In Reply.—  The purpose of the article entitled "Incidence of Acute Mountain Sickness at Intermediate Altitude" was to alert physicians that this is a real syndrome. Dr Houston clearly concurs. Where we differ is in our definitions of "acute mountain sickness." Our study1 included subjects with mild symptomatology, albeit symptoms not from travel or hypochondriasis, as was shown by the paucity of these symptoms in the sea-level control group. If our definition of acute mountain sickness had required disabling symptoms needing medication, the incidence would be 12%, about what Dr Houston predicts. As noted in the article,2 the even higher incidence in the placebo group of the dexamethasone treatment study is probably a consequence of selection, as subjects with a history of a disease are more likely to enter a drug trial. Perhaps more important than "accurate epidemiologic" research is a consensus on the nomenclature of the altitude-related

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