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  1. R McL Niven1,
  2. S Burge2,
  3. D Fishwick3,
  4. H C Francis1
  1. 1
    North West Lung Research Centre, Wythenshawe Hospital, Manchester, UK
  2. 2
    Occupational Lung Disease Unit, Birmingham Heartlands Hospital, Birmingham, UK
  3. 3
    Centre for Workplace Health, Health & Safety Laboratory, Buxton & University of Sheffield, UK
  1. Helen C Francis, Clinical Scientist, North West Lung Research Centre, Wythenshawe Hospital, Manchester, UK; helen.c.francis{at}

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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 …

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  • Competing interests: None.

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