Letters

Authors' reply

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7064.1082b (Published 26 October 1996) Cite this as: BMJ 1996;313:1082
  1. Dawood Darbar, Research fellow,
  2. Allan D Struthers, Professor of clinical pharmacology
  1. Vanderbilt University School of Medicine, Nashville, TN 37232–6602 USA
  2. Department of Clinical Pharmacology, Ninewells Hospital and Medical School, Dundee DD1 9SY

    EDITOR,—We agree with Nicholas J Linker and Adam P Fitzpatrick that a QTc dispersion of 60 ms1/2 would be insufficient in clinical practice to alter the management of a patient with peripheral vascular disease. However, we chose this cut off point because it had optimal sensitivity and specificity in predicting cardiac death and was based on the receiver operating characteristic curve. All cut off points are artificial to some extent and highly dependent on the population studied. The risk of cardiac death is likely to increase as QTc dispersion increases, but our study was too small to show this. Clearly, a QTc dispersion of >100 ms1/2 is much more meaningful in clinical practice and …

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