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September 14, 1994

Efficacy of BCG Vaccine-Reply

Author Affiliations

Technology Assessment Group Harvard School of Public Health Boston, Mass

JAMA. 1994;272(10):766. doi:10.1001/jama.1994.03520100029017

In Reply.  —We thank Dr Bellin, Dr Wheeler and colleagues, and Dr Comstock for their comments. These authors raise concerns about the interpretation of our meta-analysis.Bellin feels more weight should be given to the Madras trial, done in southern India, before considering BCG vaccine use in the United States. Wheeler et al feel that only US studies are relevant to considering BCG vaccine use in the United States. Our analysis attempted to take advantage of all available studies that met predetermined eligibility criteria. We believe that studies in many geographic areas are germane to the main purpose of our study, namely, characterizing the efficacy of BCG vaccine and reasons for heterogeneity in observed results.Wheeler et al question the methodology used for the meta-analysis. The National Research Council strongly recommended the random-effects approach we used.1Wheeler et al and Bellin are worried about undue influence of smaller studies

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