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Response to commentary by Schneck
Journal of Pediatric Urology (2011) 7, 637
Response to commentary by Schneck Janelle Fox*, Stephen Kramer Mayo Clinic, Urology, 200 First Street SW, Rochester, MN 55905, United States Received 2 June 2011; accepted 5 June 2011 Available online 29 June 2011 Retrospective analyses that seek to determine the incidence of a particular disease are often problematic, especially when the context of testing ordered cannot be determined. Empirically noticing an association of vesicoureteral reflux (VUR) in children treated for urachal anomalies (UA), we embarked on a retrospective review as a pilot study to determine the merit of this theoretical association. Family history of VUR and urinary tract infection are known to be associated with increased risk of VUR, and currently these risk factors are utilized to screen for
reflux. If screening children with UA has the potential to detect nearly a 2/3 incidence of VUR in a child, arguably this is an important factor. Presuming the hypothesis of higher VUR incidence in children with UA, we hope prospective studies will answer the following: 1) Is there a true association of VUR in children with UA, above the baseline 1% population risk? (Selective ordering of VCUG can certainly introduce bias within this study.) 2) Will detection of VUR in the context of a UA have any clinical significance for the child?
DOI of original article: 10.1016/j.jpurol.2011.04.001. * Corresponding author. Tel.: þ1 507 993 5080; fax: þ1 507 284 4951. E-mail address: [email protected] (J. Fox). 1477-5131/$36 Published by Elsevier Ltd on behalf of Journal of Pediatric Urology Company. doi:10.1016/j.jpurol.2011.06.003
Response to commentary by Schneck Janelle Fox*, Stephen Kramer Mayo Clinic, Urology, 200 First Street SW, Rochester, MN 55905, United States Received 2 June 2011; accepted 5 June 2011 Available online 29 June 2011 Retrospective analyses that seek to determine the incidence of a particular disease are often problematic, especially when the context of testing ordered cannot be determined. Empirically noticing an association of vesicoureteral reflux (VUR) in children treated for urachal anomalies (UA), we embarked on a retrospective review as a pilot study to determine the merit of this theoretical association. Family history of VUR and urinary tract infection are known to be associated with increased risk of VUR, and currently these risk factors are utilized to screen for
reflux. If screening children with UA has the potential to detect nearly a 2/3 incidence of VUR in a child, arguably this is an important factor. Presuming the hypothesis of higher VUR incidence in children with UA, we hope prospective studies will answer the following: 1) Is there a true association of VUR in children with UA, above the baseline 1% population risk? (Selective ordering of VCUG can certainly introduce bias within this study.) 2) Will detection of VUR in the context of a UA have any clinical significance for the child?
DOI of original article: 10.1016/j.jpurol.2011.04.001. * Corresponding author. Tel.: þ1 507 993 5080; fax: þ1 507 284 4951. E-mail address: [email protected] (J. Fox). 1477-5131/$36 Published by Elsevier Ltd on behalf of Journal of Pediatric Urology Company. doi:10.1016/j.jpurol.2011.06.003