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July 8, 1992

Social and Economic Factors in Patients With Coronary Disease-Reply

Author Affiliations

Duke University Medical Center Durham, NC

JAMA. 1992;268(2):197. doi:10.1001/jama.1992.03490020039018

In Reply.  —Dr Burke raises several issues. Our "close confidant" variable was a single question asking the patient whether they had someone they felt close to and could confide in (see Table 2 in our article). In our studies to date, we found social support to be distinct from depression, although there may be a relationship between the two constructs. We did not specifically evaluate "living alone."We are glad to see that Dr Lux is faithfully attending the continuing medical education lectures at his hospital, and we agree with his suggestion that much clinical research (especially clinical trials) requires a more careful interpretation than is available from reading the conclusions of papers in the medical literature. There is a growing consensus that social support needs to be tested in randomized trials, and Frasure-Smith and Prince1 have recently reported favorable effects on mortality after MI with such an intervention