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September 2, 1974

Urea and the Sickle Cell Crisis

Author Affiliations

Blodgett Memorial Hospital Grand Rapids, Mich
Wayne State University Detroit

JAMA. 1974;229(10):1285. doi:10.1001/jama.1974.03230480013010

To the Editor.—  Intravenous urea therapy for acute sickle cell crisis has been evaluated as ineffective in controlled studies undertaken by the Co-operative Urea Trials Groups.1,2 These reports are flawed by (1) a breach of the scientific method and (2) an overreaching and therefore misleading conclusion. The dazzling demonstration of scientific amenities in these articles may divert the reader from serious defects. The statement that we have stated and published several times has never been challenged and still holds: Where our protocols have been faithfully followed, there has not been a therapeutic failure, a medical misadventure, or a death.It is a fundamental rubric of science that investigators first duplicate original methods to verify claims. This principle was violated in these reports since protocols other than ours were used in these studies. Furthermore, the conclusion that intravenous urea therapy is ineffective in acute sickle cell crisis is too broad