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Self reported outcomes and adverse events after medical abortion through online telemedicine: population based study in the Republic of Ireland and Northern Ireland

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2011 (Published 16 May 2017) Cite this as: BMJ 2017;357:j2011

Re: Self reported outcomes and adverse events after medical abortion through online telemedicine: population based study in the Republic of Ireland and Northern Ireland

I am concerned that you claim your study shows telemedicine abortions are safe, and in particular you cite a zero death rate, all on self-reported data (self-reported deaths being rare). You cover for this by writing essentially that a death would have been big news and you would have heard about it somehow. This seems an untenable conclusion. You have no reasonable way of detecting deaths in your methodology, indeed there was no attempt to, and although deaths resulting from these drugs would be very unlikely, this conclusion is simply not warranted. It should be removed.

You go on to write that rates of adverse events, which thankfully could be self-reported, where women sought medical care for 'a symptom of a potentially serious complication' were low at 95.0%, which I assume was another error - but the actual figure of 9.5% does not sound low to me, especially in the context of telemedicine where I imagine there are limits on continuity of care.

Competing interests: No competing interests

19 May 2017
Ross A Kirkbride
GP
Harborne