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Regarding the study of vaccinations and subsequent optic neuritis by the Centers for Disease Control and Prevention (CDC),¹ the authors made a curious choice of statistical methods. They had access to the Defense Medical Surveillance System (DMSS), an extremely rich database that includes all immunizations, diagnoses for all inpatient and outpatient medical encounters, and additional information for more than 10 million military person-years.

Power

Instead of using this database to perform a highly powered study, a case-control method was chosen, although this method is known to provide relatively weak evidence and is often subject to bias, especially in the selection of controls. The study's power was reduced further by restricting the duration of analysis to 6-, 12-, and 18-week periods following vaccination rather than leaving open-ended the period during which optic neuritis cases were diagnosed after vaccination. In 2003, a congressionally mandated Institute of Medicine report urged the CDC to use . . . [Full Text of this Article]

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AUTHOR INFORMATION
Meryl Nass, MD

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