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Occupational and Environmental Medicine 2008;65:215-216; doi:10.1136/oem.2007.036459
Copyright © 2008 by the BMJ Publishing Group Ltd.

POSTSCRIPT

Letters

Authors’ reply

R McL Niven1, S Burge2, D Fishwick3, H C Francis1

1 North West Lung Research Centre, Wythenshawe Hospital, Manchester, UK
2 Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Birmingham, UK
3 Centre for Workplace Health, Health & Safety Laboratory, Buxton & University of Sheffield, UK

Correspondence to:
Helen C Francis, Clinical Scientist, North West Lung Research Centre, Wythenshawe Hospital, Manchester, UK; helen.c.francis@manchester.ac.uk

The first 150 words of the full text of this article appear below.

We are writing in response to the editorial1 relating to our previously published paper on a consensus study defining occupational asthma and confirming the diagnosis (Occup Environ Med 2007;64:361–5). We feel that the editorial reads more into the RAND consensus approach than the technique allows. The RAND process is a validated approach to develop consensus in situations where no gold standard or formal agreement exists. It is not possible to deviate from the technique even if the researchers do not fully support the consensus outcomes. We do not believe that the RAND technique is sufficiently robust to interpret small differences in scores—for example, from 7–9 in our original paper.

We agreed that all the usual tests should be available in specialised centres, including spirometry, peak flow monitoring and OASYS computer plotting, non-specific bronchial reactivity, specific IgE to occupational allergens, workplace challenges, specific occupational challenge tests and . . . [Full text of this article]


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