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To the Editor: I have a number of concerns about the meta-analysis by Dr Devereaux and colleagues.¹ First, the authors excluded a number of articles from their synthesis of findings that address the private vs public comparison. The majority of excluded articles found no differences in mortality between private for-profit and not-for profit facilities when public facilities are included. Furthermore, 3 of the 8 studies were doctoral dissertations. In fact, 1 dissertation appears to be included as 2 separate studies. Another study is an article by the author of this dissertation which appears based on the dissertation data. In total, there appear to be only 6 independent studies, one of which was a letter to the editor.

A second problem involves the apparent absence for controls for social factors that influence mortality among patients requiring dialysis. For example, Avorn et al² reported that failure to consult with a nephrologist at . . . [Full Text of this Article]

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