To the Editor.
—The article "Characteristics of Women With and Without Breast Augmentation"1 suggests that characteristics of women with breast augmentation may confound the relationship between silicone gel breast implants and connective tissue disease. Because research on breast implants is of immediate interest to the media and is potentially powerful in controversial litigation, researchers should be exceptionally careful in their analysis and presentation of data. Reliance on scientific findings published in peer-reviewed journals has become increasingly important since the 1993 Daubert2decision, which changed the evidentiary standard from "principles and methods generally accepted in the scientific community" to "evidentiary reliability... based on scientific validity."A careful reading of the study by Dr Cook and colleagues1 reveals several weaknesses that challenge the implications of the study for understanding the relationship between silicone gel implants and disease.First, the analysis draws on existing data from 2 samples designed to study
Stewart MW, Elliott M. Characteristics of Women With and Without Breast Implants. JAMA. 1997;278(10):818. doi:10.1001/jama.1997.03550100044024