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Neurotron, Inc., Evergreen Medical Consultants, Evergreen, CO
To the Editor:
The article by Shimoda and Ikuta (1) was informative and well written. The coefficients of variation (CV) for repeated measures were not considered in the statistical analysis, and consequently their conclusions are erroneous. The reported CV for CPT measures varies from 4.7% to 27.5% depending on the CPT stimulus frequency (2–5). The difference of the mean CPT measures at each frequency between the horizontal and 70° tilt-up position fell within the previously published CV. Although these changes in CPTs might have been statistically significant, they might not be clinically relevant. Clinical significance is based on the determination of whether the analysis of the measure reveals if it is normal or abnormal and how severe. All the CPT measures in this study remained well within the established normative variables. Interestingly, the authors point out that there is a relationship between hypertension and pain perception. Assessment of pain tolerance thresholds using the same device as used in this study (Neurometer® CPT/C; Neurotron, Inc., Baltimore, MD) is possible (6). Perhaps assessment of pain tolerance thresholds would have yielded more significant results.
Dr. Shimoda does not wish to respond.
References
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