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Comment & Response
December 2018

Limitations to the Association of Risk of Airway Disease With Removal of Adenoids and Tonsils in Children—Reply

Author Affiliations
  • 1Melbourne Integrative Genomics, University of Melbourne, Parkville, Victoria, Australia
  • 2Centre for Social Evolution, Department of Biology, University of Copenhagen, Copenhagen, Denmark
  • 3Department of Ecology and Evolutionary Biology, Yale University, New Haven, Connecticut
JAMA Otolaryngol Head Neck Surg. 2018;144(12):1188-1189. doi:10.1001/jamaoto.2018.2437

In Reply Four main issues were raised by Kitipornchai and Mackay and Lüscher et al. All of them appear invalid as challenges of our main results.1

1. Our study1 rigorously accounted for the biases mentioned by Mackay and Kitipornchai. We tested for differences in baseline characteristics ensuring that control/intervention groups did not differ presurgery, which protected our analyses against preexisting differences in health burden, ie, selection bias. Denmark comprehensively tracks individual health/disease from birth to death because free health care requires registration for all hospital-related diagnoses. The validity of these records is therefore unaffected by socioeconomic status as in most other countries, particularly the United States. These circumstances enabled us to employ multiple controls1 protecting considerably against confounding, reverse causality and measurement bias.

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