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To the Editor: Dr Imai and colleagues¹ investigated the association between changes in plasma levels of soluble Fas ligand and changes in creatinine in patients with acute respiratory distress syndrome (ARDS). However, I disagree with their method of computing the magnitude and direction of correlation.

The plasma samples were obtained from patients with ARDS treated with either conventional strategy (control group) or protective ventilatory strategy (lung protection group) in a previous randomized clinical trial.² The authors reported that the mean plasma levels of soluble Fas ligand were significantly higher in the control group compared with the lung protection group at 2 different time points. This means that different treatment strategies changed the characteristics of soluble Fas ligand. In addition, the authors illustrated the association between changes in plasma levels of soluble Fas ligand and changes in levels of creatinine. The authors' figure indicates that the control group had a positive . . . [Full Text of this Article]

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