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—We regret that Dr Kirkland failed to read or to understand the sentence in the "Methods" section of our article that defined "sudden unexpected death": "The diagnosis of sudden unexpected death was made when a patient who had no previous clinical diagnosis of coronary heart disease died within 24 hours of the onset of symptoms typical or suggestive of acute myocardial infarction."As wrongly implied by Dr Kirkland, we did not apply the term to any patient who survived more than 24 hours.We combined the analysis of the group of patients who presented with sudden unexpected death and those who presented with myocardial infarction to avoid the misinterpretation that can occur when the experience of patients with one or the other diagnoses is analyzed in isolation.Misinterpretation might result, for example, if two different groups of patients have similar survival rates but one group is consistently more
Kottke TE, Bailey KR, Orencia AJ, Yawn BP. Relax: It's Onlie Sodeyne Death-Reply. JAMA. 1993;270(16):1935. doi:10.1001/jama.1993.03510160053027