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Association is not the same as causation
  1. MARTIN RICHARDSON, Consultant Paediatrician
  1. Peterborough District Hospital
  2. Peterborough, UK
  3. martin.richardson{at}

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    Editor,—The paper by Kerr et al describes an association between SIDS and colonisation withH pylori. In the introduction, the authors state that both SIDS and colonisation with H pylori are known to be linked with poor socioeconomic status and overcrowding. This clearly suggests that some common factor (possibly smoking, possibly something else) may predispose to both conditions. Yet, in the discussion, the authors ignore this possibility and prefer to postulate on how H pylori might cause sudden unexpected death. Not only is this approach unscientific, it is also irresponsible. The proposed causation has been taken up by the media and I have already been asked to see a mother who is receiving eradication therapy for H pylori. She fears that her child may already be infected and will die from cot death.

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