BMJ 1996;313:944 (12 October)

Letters

Misdiagnosis certainly occurs

EDITOR,--It is gratifying, though alarming, that Keith Andrews and colleagues' study1 so closely duplicates our findings regarding misdiagnosis of the vegetative state.2 The accompanying editorial by Ronald Cranford, which suggests that the rate of misdiagnosis is a new finding and that Andrews and colleagues' methods were questionable, merits critical comment.3

Aside from the implication that physicians who provide rehabilitative care are scientifically suspect, Cranford shows his inexperience in the neurorehabilitation of brain injured patients when he doubts the veracity of the buzzer communication system.3 Prosthetic communication and environmental control systems, including simple on-off switching devices like the buzzer, are commonly used in rehabilitation.4 Obviously, the patients in Andrews and colleagues' study were showing the responsiveness required to negate a diagnosis of vegetative state before they could use a communication device with 90% consistency.

Cranford--a member of the Multi-Society Task Force on Persistent Vegetative State--says that neurodiagnostic tests have "some use . . . [Full text of this article]


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Relevant Article

Misdiagnosis of the vegetative state: retrospective study in a rehabilitation unit
Keith Andrews, Lesley Murphy, Ros Munday, and Clare Littlewood
BMJ 1996 313: 13-16. [Abstract] [Full Text]

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