BMJ  2004;329:172 (17 July), doi:10.1136/bmj.329.7458.172

Letter

Ginkgo biloba and acetazolamide for acute mountain sickness

Bias in participants may underestimate effectiveness of agents

The first 150 words of the full text of this article appear below.

EDITOR—In their randomised controlled trial of gingko biloba and acetazolamide for preventing acute mountain sickness Gertsch et al do not include data on eligible trekkers who declined enrolment.1 These data are important as the trial participants may not be representative of all non-Nepali trekkers. A bias in participants may underestimate the effectiveness of either agent. This is particularly important for gingko, which is stated to be no more effective than placebo.

Credit: ERNST HAAS/GETTY

Many trekkers arriving in Nepal will have established views on drug treatments for altitude sickness. Some will already be in possession of their drug of choice. Such people are likely to refuse randomisation to drug or placebo and will therefore have been excluded from the trial. If a significant number of these had perceived prior benefit from gingko, its effectiveness will have been underestimated.

From the information provided it is impossible to comment on . . . [Full text of this article]

Heather L Elphick, specialist registrar, geriatric medicine

Northern General Hospital, Sheffield S5 7AU elphickdh@hotmail.com

David A Elphick, specialist registrar, gastroenterology

Royal Hallamshire Hospital, Sheffield S10 2JF


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Relevant Article

Randomised, double blind, placebo controlled comparison of ginkgo biloba and acetazolamide for prevention of acute mountain sickness among Himalayan trekkers: the prevention of high altitude illness trial (PHAIT)
Jeffrey H Gertsch, Buddha Basnyat, E William Johnson, Janet Onopa, and Peter S Holck
BMJ 2004 328: 797. [Abstract] [Full Text] [PDF]

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