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The comments by Dr. Daniel in response to the article "Incidence of Diagnosed Clinical Otosclerosis" indicate that several points made in the article need expansion. Dr. Daniel has questioned the importance of incidence data based on a homogenous population to researchers seeking to understand a disease, and we might add, to physicians seeking to treat it.
Dr. Daniel's summary statement "any incidence study without hypothesis(es) as to how this incidence came to be so or mention of any intervening variable that may aid in the prediction of its occurrence is of extremely limited value" seems contrary to the fundamental principles of scientific investigation. There is a need, first, for descriptive studies to identify patterns of disease (whether clinical or epidemiological) from which one can then develop such hypotheses. The epidemiological studies of multiple sclerosis are illustrative of this principle; geographic and ethniic patterns become apparent as various population groups are
PEARSON RD. Incidence of Diagnosed Clinical Otosclerosis-Reply. Arch Otolaryngol. 1974;100(3):245–246. doi:10.1001/archotol.1974.00780040253023
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