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Marc D. Basson, MD
Columbia-Presbyterian Medical Center New York

JAMA. 1981;246(1):41.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The article by Koplan et al (1980;244:2736) on prophylaxis for isoniazid-resistant tuberculosis presents an interesting model for clinical decision making in the absence of clear data, employing a Delphi poll of presumed experts to establish a consensus. The authors rightly recognize that such a poll may be a useful stopgap until the performance of a more definitive study. However, although "clinical and public health decision making frequently occurs with an incomplete data base," it is equally important not to give the appearance of consensus where none exists.

Five different therapeutic plans were endorsed by the responding experts who had been surveyed regarding treatment of children with positive skin test results and known exposure to isoniazid-resistant tuberculosis. Seven percent of these experts urged no treatment at all. Roughly one third each urged treatment with isoniazid alone or rifampin alone, and another 23% were divided between two multidrug therapies. . . . [Full Text PDF of this Article]

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