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June 9, 1997

Intervention After Myocardial Infarction-Reply

Author Affiliations

Vancouver, British Columbia

Arch Intern Med. 1997;157(11):1268-1269. doi:10.1001/archinte.1997.00440320178024

West and Jones criticize our review article' as selective and, in consequence, overly optimistic in its conclusions. Our findings about the benefit of psychosocial interventions are indeed quite optimistic. Before being universally accepted as meaningful, such positive conclusions are first subjected to critical reviews in a blind review process prior to publication, and are also often subjected to rigorous reexamination by peers using "methodological magnifying glasses" in letters to the editor. This is exactly what West and Jones have done. The best research, of course, is the kind that can be successfully defended against criticisms, and this is attempted below.

West and Jones doubt the generalizability of our conclusion because we included a number of studies with small sample sizes. Sample size is an important feature within a single study because of its impact on power to detect differences. Sample size is also critical in meta-analyses unless it is controlled

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