Drawing Conclusions about Short-Term Variability in Liver Function Test Results

  1. Mariana Lazo, MD, ScM;
  2. Elizabeth Selvin, PhD, MPH; and
  3. Jeanne M. Clark, MD, MPH
  1. From Johns Hopkins University, Baltimore, MD 21205.

    IN RESPONSE:

    We appreciate the readers' interest in our study. As indicated by Drs. Arora and Triadafilopoulos, because our study was based on a nonrandom sample of the NHANES III population, selection bias remains a possibility. However, even if selection bias were present, it doesn't change the fact that, although sociodemographic and other patient-level characteristics may be associated with the absolute level of liver enzymes, such factors are unlikely to affect variability, which is a biological phenomenon. Indeed, we did not observe differences in estimates of variability by demographic or other patient-level …

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