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John C. Rotschafer, PharmD
St Paul-Ramsey Medical Center University of Minnesota Minneapolis

Lois Shikuma, PharmD; Francis Lam, PharmD
St Paul-Ramsey Medical Center

JAMA. 1986;256(7):865-866.

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

In Reply.—

Removing the earliest clinical trial from the data used to derive the published nomogram because the "year of study" was significantly different from other clinical trials in the same institution raises several questions as to whether the proposed model can be applied consistently within the authors' institution and other institutions such as ours. What was different? The protocols are remarkably similar, especially in terms of aminoglycoside therapy.

Moore et al, using a cutoff point of 0.75, generate data in an additional 143 medical and surgical patients. In these data, they indicate a sensitivity (true-positive test result) of 73%. What they do not point out is that the data presented have a false-negative rate of 27%. Thus, we continue to question the usefulness of this model on a prospective basis for decision analysis.

We would also like to question whether the initial creatinine clearance is an a priori discriminator . . . [Full Text PDF of this Article]

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