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research" as the "primary strengths of registries are their large sample sizes and generalizability." 1 They also suggest that I used "invalid comparisons" and misinterpret the "clinical impact" of their research. I will answer each of these issues in turn. Registries are often large and large samples increase precision. Unfortunately, an estimate can be both wonderfully precise and highly biased. I could accurately measure the height of the tallest member of each high school classroom in Los Angeles every week for the entire year (even measuring the same child more than once, as could be done with patients in ADHERE). I would have a large sample, and could calculate a mean height with narrow confidence intervals (great precision). This mean height would hardly be generalizable to all high school students in Los Angeles, or to those in any other city for that matter. If I made my registry even larger, by sampling every high school in California using the same methods, the sample would be even larger, the confidence interval narrower, but the estimate no less biased. Dr. Collin's assertion that big is better misses this crucial point. Unless a registry includes all eligible subjects

Who reads Response to: Critical Care Medicine Training and Certification for Emergency Physicians?

Author

Robert S. Green

Publisher

Elsevier Science; Elsevier ; Mosby Inc.; Elsevier BV (ISSN 1097-6760)

Published

2006

Language

EN

Field

Medicine (Health Sciences)