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   Table of Contents      
CORRESPONDENCE
Year : 2020  |  Volume : 152  |  Issue : 1  |  Page : 120

Authors' response


1 Translational Global Health Policy Research Cell, New Delhi, India
2 Multidisciplinary Research Unit/Model Rural Health Research Unit, New Delhi, India
3 ICMR-National Institute of Medical Statistics, New Delhi, India
4 Division of Reproductive Biology, Maternal Health & Child Health, New Delhi, India
5 Division of Non-Communicable Diseases, Indian Council of Medical Research, New Delhi, India
6 Division of Clinical Medicine, ICMR-National Institute of Cholera & Enteric Diseases, Kolkata, West Bengal, India
7 Informatics, Systems & Research Management Cell, Indian Council of Medical Research, New Delhi, India
8 Division of Epidemiology & Communicable Diseases, Indian Council of Medical Research, New Delhi, India
9 Department of Health Research, Ministry of Health & Family Welfare; Indian Council of Medical Research, New Delhi, India
10 ICMR-National AIDS Research Institute, Pune, Maharashtra, India

Date of Web Publication17-Jul-2020

Correspondence Address:
Samiran Panda
ICMR-National AIDS Research Institute, Pune, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0971-5916.290073

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How to cite this article:
Chatterjee P, Anand T, Singh KJ, Rasaily R, Singh R, Das S, Singh H, Praharaj I, Gangakhedkar RR, Bhargava B, Panda S. Authors' response. Indian J Med Res 2020;152:120

How to cite this URL:
Chatterjee P, Anand T, Singh KJ, Rasaily R, Singh R, Das S, Singh H, Praharaj I, Gangakhedkar RR, Bhargava B, Panda S. Authors' response. Indian J Med Res [serial online] 2020 [cited 2021 Jul 27];152:120. Available from: https://www.ijmr.org.in/text.asp?2020/152/1/120/290073

We thank the authors for their close reading of our article and comments on the same[1]. The preferred approach to select controls in a case-control study is to sample controls from a population which could have become cases in the study, had they developed the disease. In the investigation we conducted, controls had symptoms like that of the cases, but were not detected to have SARS-CoV-2 infection on real-time reverse transcription-polymerase chain reaction (RT-PCR) test, and thus qualified to be considered as controls. This similarity between cases and controls added strength to the process followed by us in the selection of controls and minimized biases, which could have otherwise been introduced if separate sampling considerations for cases and controls would have been used.

Contrary to the statement by the authors, we identified potential benefit of exposure to hydroxychloroquine (HCQ) in the univariate analysis and indicated the same in the results[1]. While doing so, we remained cognizant of the fact that the precision of a 95 per cent confidence interval is guided by the width of the interval (which was narrow in our study), rather than solely by the inclusion of null or any specific value within an interval[2]. Further, the adverse effects experienced by the study participants, during the course of HCQ intake as prophylaxis, were self-reported. As such, there were no provisions for undertaking specific adverse event monitoring within the mandate of the current design except for brief telephonic interviews.

While we reiterate that the evidence from randomized controlled trials (RCTs) are awaited to support further actions pertaining to pre-exposure prophylaxis, the RCT on post-exposure prophylaxis, cited by the authors, refers to a completely different clinical context[3]. The findings of the cited RCT had their own strengths and limitations, which were aptly elaborated upon in an accompanying editorial[4].

 
   References Top

1.
Chatterjee P, Anand T, Singh KJ, Rasaily R, Singh R, Das S, et al. Healthcare workers & SARS-CoV-2 infection in India: A case-control investigation in the time of COVID-19. Indian J Med Res 2020; 151 : 459-67.  Back to cited text no. 1
    
2.
Greenland S, Senn SJ, Rothman KJ, Carlin JB, Poole C, Goodman SN, et al. Statistical tests, P values, confidence intervals, and power: A guide to misinterpretations. Eur J Epidemiol 2016; 31 : 337-50.  Back to cited text no. 2
    
3.
Boulware DR, Pullen MF, Bangdiwala AS, Pastick KA, Lofgren SM, Okafor EC, et al. A randomized trial of hydroxychloroquine as postexposure prophylaxis for COVID-19. N Engl J Med 2020; NEJMoa2016638.   Back to cited text no. 3
    
4.
Cohen MS. Hydroxychloroquine for the prevention of COVID-19 - searching for evidence. N Engl J Med 2020; NEJMe2020388.  Back to cited text no. 4
    




 

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