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Unexplained Noncardiac Chest Pain
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
TO THE EDITOR:
Rao and colleagues [1] recently reported interesting differences between the esophageal mechanical properties of patients with noncardiac chest pain and those of healthy controls. However, controls were significantly younger than patients. In the same issue, Frobert and colleagues [2] report that whereas reflux episodes peak at the same time as noncardiac pain, reflux also peaks in a control group at the same time: This is a good demonstration that correlation does not mean causation.
In the case of esophageal planimetry, how much of the difference in mechanical properties and the lowering of sensation thresholds was due to age-related change alone? Were the patients who did not experience pain with planimetry younger than those who did? Is there a set of age-adjusted normal values for esophageal planimetry? Given the wide overlap of values between patients and controls in the study by Rao and colleagues, as was noted in Goyal's editorial [3], accounting for this simple difference in groups may make this new technique much more or less interesting.
Frederick L. Jones III, MD
University of Pennsylvania School of Medicine; Philadelphia, PA 19104
The Editors welcome submissions for possible publication in the Letters section. Authors of letters should:
•Include no more than 300 words of text, three authors, and five references
•Type with double-spacing
•Send three copies of the letter, an authors' form signed by all authors, and a cover letter describing any conflicts of interest related to the contents of the letter.
Letters commenting on an Annals article will be considered if they are received within 6 weeks of the time the article was published. Only some of the letters received can be published. Published letters are edited and may be shortened; tables and figures are included only selectively. Authors will be notified that the letter has been received. If the letter is selected for publication, the author will be notified about 3 weeks before the publication date. Unpublished letters cannot be returned.
Annals welcomes electronically submitted letters.
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