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November 13, 1991

Digoxin in Congestive Heart Failure-Reply

Author Affiliations

University of Southern California Los Angeles

University of Southern California Los Angeles

JAMA. 1991;266(18):2559-2560. doi:10.1001/jama.1991.03470180059025

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In Reply.  —Clinical decision making on choice of drug therapy and their combination is complex and is guided by an information base that is derived from many sources, including results of studies and trials that are well designed and performed and also properly analyzed, as well as those from "clinical memory."The purpose of our article was to review briefly the information base and come to what we believe were reasonable and appropriate conclusions from the currently available data. Others may choose to come to somewhat different conclusions; however, it is reasonable that they carefully and thoroughly review for themselves the original publications and take into account others' clinical memory if theirs is only a brief one. Drs Tanenbaum and Feldman did not define what they meant by "informed" and "uninformed practitioners." If a practitioner ignores the data (cited in our article) that demonstrate diuretics alone are not as effective