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To the Editor:—
Dr. Cynthia Stoltze Hardison's answer to Dr. A. J. Greenbank's query on routine tests in screening for hemophilia (Questions and Answers, JAMA178:783 [Nov. 18] 1961) has completely nullified what little progress I had made in educating the medical staff on the gross inadequacies of "routine" bleeding and clotting times for the detection of unsuspected bleeding disorders. Dr. Hardison suggests that routine tests are indicated and that this routine should include a bleeding time and a coagulation time. This suggestion is contrary to an extensive body of knowledge. Wilkinson et al. (Lancet2:947-950 [Oct. 28] 1961), found that of 214 patients with hemophilia only 42% had abnormal coagulation times; and that of 38 patients with PTC deficiency only 53% had abnormal coagulation times. On the other hand, of the total of 267 cases with either hemophilia or PTC deficiency, 93% had clinical symptoms of excessive
Gambino SR. Hemophilia. JAMA. 1962;179(9):742. doi:10.1001/jama.1962.03050090070019
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