Ali, Syed Ahsan

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eCommons@AKUSection of Gastroenterology Department of MedicineJune 2017Response to comment on Ahsan Ali Syed et al ( JPak Med Assoc 2017; 67: 400-404 Frequency ofworsening liver function in severe dengue hepatitispatients receiving paracetamol: A retrospectiveanalysis of hospital dataSyed Ahsan AliAga Khan University, syed.ahsan@aku.eduFollow this and additional works at: https://ecommons.aku.edu/pakistan_fhs_mc_med_gastroenterolPart of the Gastroenterology CommonsRecommended CitationAli, S. A. (2017). Response to comment on Ahsan Ali Syed et al ( J Pak Med Assoc 2017; 67: 400-404 Frequency of worsening liverfunction in severe dengue hepatitis patients receiving paracetamol: A retrospective analysis of hospital data. Journal of Pakistan MedicalAssociation, 67(6), 967.Available at: https://ecommons.aku.edu/pakistan_fhs_mc_med_gastroenterol/224Thank you Dr. Yakoob for taking interest in our article.Having received your feedback and critique, we would liketo respond to the comments. Firstly, we agree that our data had both before and aftervalues of ALT for patients with severe dengue hepatitis.However to clarify, we did not do a matched before-afteranalysis as the objective was instead to compare thebefore Paracetamol ALT values of those who improvedwith the before values of those who worsened, andsimilarly the ALT values after Paracetamol administrationvalues for both those who improved with those whoworsened in order to demonstrate a statisticalrelationship. In such an un-matched situation, we believethe Mann Whitney U test is valid.1 Also to mention thatour choice of the non-parametric test was based on thevisual assessment and statistical test for data normality.This non-parametric nature of data is also reflected in thedescriptive statistics, where we reported the medianinstead of the mean. We regret that this detail was notincluded in the final manuscript. Secondly, we appreciate your suggestion for a multi-variable analysis to account for an enriched statisticalanalysis, however, the authors resorted to a descriptiveanalysis of this retrospective data due to a small samplesize, which could only be obtained after acomprehensive screening of over 2000 relevant files.Any original associations that may exist are likely to bemasked as a function of the small sample size, reflectinga type II error.2Our patient data had limited number of pertinentvariables for a robust analysis, but presents a descriptivepicture that provides groundwork for larger, prospectiveand preferably multi-center studies that are adequatelypowered to detect associations. The authors encouragethis way forward as an objective approach for futureresearch. References1. McKnight PE, Najab J. Mann?Whitney U Test. Corsini Encyclopediaof Psychology. 2010.2. Hosmer Jr DW, Lemeshow S, Sturdivant RX. Applied logisticregression: John Wiley & Sons; 2013.J Pak Med Assoc967LETTER TO THE EDITORResponse to comment on Ahsan Ali Syed et al (J Pak Med Assoc 2017; 67: 400-404Frequency of worsening liver function in severe dengue hepatitis patientsreceiving paracetamol: A retrospective analysis of hospital dataSyed Ahsan AliDepartment of Medicine, The Aga Khan University Hospital, Karachi.Correspondence: Email: syed.ahsan@aku.edu

Response to comment on Ahsan Ali Syed et al (J Pak Med Assoc 2017; 67: 400-404 Frequency of worsening liver function in severe dengue hepatitis patients receiving paracetamol: A retrospective analysis of hospital data

https://ecommons.aku.edu/cgi/viewcontent.cgi?article=1223&amp;context=pakistan_fhs_mc_med_gastroenterol

Response to comment on Ahsan Ali Syed et al (J Pak Med Assoc 2017; 67: 400-404 Frequency of worsening liver function in severe dengue hepatitis patients receiving paracetamol: A retrospective analysis of hospital data

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