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January 24, 1959


Author Affiliations

Surgical Clinic Centrallasarettet Östersund, Sweden.

University of Uppsala Östersund, Sweden.

JAMA. 1959;169(4):408-409. doi:10.1001/jama.1959.03000210102018

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To the Editor:—  In The Journal (168:257-261 [Sept. 20] 1958) Foster and Knutson gave some interesting data regarding the frequency of occurrence of the association of cholelithiasis, hiatus hernia, and diverticulosis coli in a hospital population. This frequency was found to be far greater than that calculated as due to random coincidence. In this calculation, however, there seem to be some possible errors which could partly or wholly account for the results of the study. First, there is a possibility of error due to differences in probability of admission to hospital for patients with the triad and patients with the single conditions. We believe it to be generally agreed that the three single conditions under study may occur without giving rise to symptoms. This implies that some patients with one or more components of the triad are not referred to hospital. Even when ideal conditions exist and all patients

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