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Inferences for health provision from survival data in cystic fibrosis
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Introduction |
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Patients with cystic fibrosis (CF), their families, carers, insurers, health care planners, and CF carriers all have an interest in knowing the lifespan of people with the disease. Evidence-based medicine is now explicitly practised by many clinicians in their everyday clinical work. This practice should include prognosis,1 where the expected lifespan is the most important statistic.
However, clinicians with a responsibility for these patients are faced with a large literature on the survival of people with CF, which presents a contradictory picture. My purpose is to show how these contradictions may be resolved by reference to other published material. I have examined three "notable" observations to show what inferences may be reasonably drawn from them concerning the lifespan of people with CF.
In the absence of properly conducted randomised controlled
clinical trials, observational methods have been used to try to determine the relative efficacy of different models of providing clinical
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