Letter to the Editor
Differences in Survival Between Patients With Systemic Lupus Erythematosus From a Public and a Private Center
Diferencias en supervivencia en pacientes con lupus eritematoso sistémico de un centro privado y uno público
Maria Claudia Godoy Carrillo
, Alejandra Meneses-Saco
Corresponding author
Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru
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These factors influence the quality of life and the degree of disease activity in a patient.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">However, the study has some limitations that put into question the reported results. First, the time at which the authors started monitoring the patients is not defined. This could bias the study because the survival prognosis of SLE varies according to several factors, including the degree of disease activity of the patient, the age and comorbidities at the time of diagnosis, among others.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a></p><p id="par0020" class="elsevierStylePara elsevierViewall">Second, the study does not determine whether patients are exclusive users of the health system (public or private), if they have access to both health systems or if, during the years of follow up, they moved from one system to another. This would lead to patients receiving more than one treatment simultaneously or different treatments in each center in different periods.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Finally, the use of informed consent is important in a study, as it ensures that the patient is aware and accepts to participate.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> It is unusual to require informed consent in a retrospective study, as the methods section says that it had not been sought, but later mentions that it was indeed obtained, which can cause confusion about the ethics of the study.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Finally, we believe that some data could have been better explained, both in tables and in text, as it can confuse readers causing misinterpretation of the data. For example, in the results section, the authors explain that, given two groups of people, both black, one with health insurance and the other without health insurance increased mortality was observed in the group without health insurance, which results in ethnicity not playing a decisive role in the survival of patients, which may be debated, since in this case, the ethnicity was the same in all patients studied, and not a variable.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Godoy Carrillo MC, Meneses-Saco A. Diferencias en supervivencia en pacientes con lupus eritematoso sistémico de un centro privado y uno público. Reumatol Clin. 2015;11:260</p>" ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Comparación de datos demográficos, presentación clínica, tratamiento y desenlace de pacientes con lupus eritematoso sistémico tratados en un centro público y otro privado de salud en Santa Fe, Argentina" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.M. Schmid" 1 => "S.G. Roverano" 2 => "S.O. Paira" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.reuma.2013.12.009" "Revista" => array:6 [ "tituloSerie" => "Reumatol Clin" "fecha" => "2014" "volumen" => "10" "paginaInicial" => "294" "paginaFinal" => "298" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24984924" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estimación de la calidad de vida relacionada con la salud y medidas de utilidad en una población de pacientes colombianos con lupus eritematoso sistémico" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C.J. Velásquez Franco" 1 => "J.J. Yépes Núñez" 2 => "K. Ariza Mendoza" 3 => "P. Isaza Arenas" 4 => "A. Gaviria Gómez" 5 => "C. Muñoz-Grajales" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Colomb Reumatol" "fecha" => "2013" "volumen" => "20" "paginaInicial" => "183" "paginaFinal" => "194" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Manifestaciones y evolución clínica de pacientes con LES en un hospital de referencia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M. Schmid" 1 => "S. Roverano" 2 => "O. Paira" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Arg Reumatol" "fecha" => "2013" "volumen" => "24" "paginaInicial" => "28" "paginaFinal" => "32" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Consentimiento informado: algunas consideraciones actuales" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Cañete" 1 => "D. Guilhem" 2 => "K. Brito" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Bioethica" "fecha" => "2012" "volumen" => "18" "paginaInicial" => "121" "paginaFinal" => "127" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognosis in systemic lupus erythematosus. Negative impact of increasing age at onset, black race, and thrombocytopenia, as well as causes of death" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "J.D. Reveille" 1 => "A. Bartolucci" 2 => "G.S. Alarcón" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arthritis Rheumatol" "fecha" => "1990" "volumen" => "33" "paginaInicial" => "39" "paginaFinal" => "47" ] ] ] ] ] ] ] ] ] ] "agradecimientos" => array:1 [ 0 => array:4 [ "identificador" => "xack180234" "titulo" => "Acknowledgement" "texto" => "<p id="par0035" class="elsevierStylePara elsevierViewall">We would like to thank Dr. Antonio Bernabé-Ortiz for his guidance in the preparation of this letter.</p>" "vista" => "all" ] ] ] "idiomaDefecto" => "en" "url" => "/21735743/0000001100000004/v1_201507020119/S2173574315000246/v1_201507020119/en/main.assets" "Apartado" => array:4 [ "identificador" => "8400" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Letters to the Editor" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735743/0000001100000004/v1_201507020119/S2173574315000246/v1_201507020119/en/main.pdf?idApp=UINPBA00004M&text.app=https://reumatologiaclinica.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173574315000246?idApp=UINPBA00004M" ]
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| 2018 March | 60 | 6 | 66 |
| 2018 February | 37 | 3 | 40 |
| 2018 January | 14 | 3 | 17 |
| 2017 December | 35 | 6 | 41 |
| 2017 November | 21 | 4 | 25 |
| 2017 October | 18 | 3 | 21 |
| 2017 September | 17 | 3 | 20 |
| 2017 August | 21 | 6 | 27 |
| 2017 July | 21 | 9 | 30 |
| 2017 June | 36 | 8 | 44 |
| 2017 May | 42 | 8 | 50 |
| 2017 April | 23 | 3 | 26 |
| 2017 March | 28 | 4 | 32 |
| 2017 February | 11 | 2 | 13 |
| 2017 January | 22 | 4 | 26 |
| 2016 December | 41 | 16 | 57 |
| 2016 November | 36 | 5 | 41 |
| 2016 October | 66 | 9 | 75 |
| 2016 September | 44 | 4 | 48 |
| 2016 August | 40 | 6 | 46 |
| 2016 July | 22 | 12 | 34 |
| 2015 December | 2 | 0 | 2 |
| 2015 November | 1 | 14 | 15 |
| 2015 October | 3 | 23 | 26 |
| 2015 September | 3 | 0 | 3 |
| 2015 August | 5 | 38 | 43 |
| 2015 July | 23 | 26 | 49 |
Show all
