A new statistical review calls into question studies that
have been taken as proof that antibiotic retreatment for
chronic Lyme disease is futile. That misunderstanding has
led to medical guidance that discourages retreatment and
insurance coverage for it. Instead, the authors of the
review suggest, the proper reading of the studies and their
data is that they prove nothing.
Most doctors treat Lyme disease with antibiotics for two to
four weeks after diagnosis, but if symptoms persist after
that, medical guidelines recommend against antibiotic
retreatment. That recommendation may not be warranted. A
newly published statistical review of the four studies upon
which those guidelines are based reports flaws in design,
analysis, and interpretation that call into question the
strength of the evidence against retreatment.
Allison DeLong, a biostatistician at Brown University's
Center for Statistical Sciences and lead author of the study
published online Aug. 19, 2012, in Contemporary Clinical
Trials, said the four studies do not prove that retreatment
does not work. That questionable interpretation, however,
has led doctors to forgo treatment and insurance companies
to withhold reimbursement.
"The goal of the paper is to clarify what was actually found
from these clinical trials and what could be said and what
couldn't be said," DeLong said. "A lack of evidence should
not be used to deny treatment when the studies have serious
flaws."
Evidence in the trials is most often inconclusive, she and
three co-authors found. Two studies even found some
statistically significant benefits from antibiotics.
data is that they prove nothing.
Most doctors treat Lyme disease with antibiotics for two to
four weeks after diagnosis, but if symptoms persist after
that, medical guidelines recommend against antibiotic
retreatment. That recommendation may not be warranted. A
newly published statistical review of the four studies upon
which those guidelines are based reports flaws in design,
analysis, and interpretation that call into question the
strength of the evidence against retreatment.
Allison DeLong, a biostatistician at Brown University's
Center for Statistical Sciences and lead author of the study
published online Aug. 19, 2012, in Contemporary Clinical
Trials, said the four studies do not prove that retreatment
does not work. That questionable interpretation, however,
has led doctors to forgo treatment and insurance companies
to withhold reimbursement.
"The goal of the paper is to clarify what was actually found
from these clinical trials and what could be said and what
couldn't be said," DeLong said. "A lack of evidence should
not be used to deny treatment when the studies have serious
flaws."
Evidence in the trials is most often inconclusive, she and
three co-authors found. Two studies even found some
statistically significant benefits from antibiotics.
