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February 8, 1985

Caffeine Analgesia-Reply

JAMA. 1985;253(6):780. doi:10.1001/jama.1985.03350300065022

In Reply.—  We have carefully considered each of the points raised by Drs Temple and Pigeon, and we find that each has either been addressed in our article or is simply incorrect.Drs Temple and Pigeon are factually wrong in asserting that it is impossible to test the validity of the model assumptions used in the bioassay analysis. We reported the results of the validity tests for each of the graded dose studies in our article.Concerning the linearity of the dose range, of the 30 studies, only two used a dose of 217 mg and four used 2,000 mg or nearly 2,000 mg. All but a few used dosages of 1, 2, and 3 or 1, 2, and 4 tablets. The analysis of each trial included a test for deviation from linearity. Consistent with chance, only one of the 30 studies evidenced a significant deviation.Regarding the proper number