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To the Editor: In their study of a yoga-based intervention for carpal tunnel syndrome, Dr Garfinkel and colleagues¹ should have included data reporting how often the 25 subjects with bilateral carpal tunnel syndrome (CTS) demonstrated similar responses in both wrists, and their data should have been analyzed by subject response rather than by wrist response.

In patients with bilateral CTS who had poor posture, shoulder girdle muscle weakness, or other proximal factors contributing to their illness, both arms would seem likely to respond to therapy in a similar way. The response in both wrists of these subjects should not, therefore, have been analyzed as independent observations; analysis by extremity overstates the statistical significance of the intervention.

It would be similarly inappropriate for physicians to analyze treatment in a cohort of patients with metastatic cancer by tabulating each metastasis that responded to chemotherapy or to determine response to antibiotics in subjects . . . [Full Text of this Article]

Marian Garfinkel, EdD
Medical College of Pennsylvania
Hahnemann University
Philadelphia, Pa

David A. Allan, MD, PhD
University of Pennsylvania Health System/
Presbyterian Medical Center
Philadelphia

H. Ralph Schumacher, Jr, MD
University of Pennsylvania School of Medicine
Philadelphia