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To the Editor.—
The report by Drs Clark and Clement in the Archives (111:731-733, 1975) that a statistically significant difference exists between the comparative clinical responses of 0.1% halcinonide cream and 0.1% betamethasone valerate cream, favoring halcinonide, should not necessarily imply that halcinonide therapy for psoriasis is superior. The overall evaluation of the two drugs based on the rapidity and completeness of their therapeutic responses failed to support the superiority of one corticosteroid cream over the other.The most likely explanation for the statistically significant comparative clinical responses vs the lack of statistical significance of the overall therapeutic responses resides with the criteria chosen to judge the separate evaluations. Those criteria used to judge the comparative clinical responses, ie, erythema, scaling, thickening, and edema would appear more subject to subtle variants than the criteria of poor to excellent used to evaluate the overall therapeutic responses. Criteria with increased sensitivity to
Amon RB. Statistical Inferences and Implications. Arch Dermatol. 1976;112(5):732. doi:10.1001/archderm.1976.01630290074024