Unacceptable Subgroups

Abstract

In his CME article on the treatment of sudden idiopathic sensorineural hearing loss, Professor Suckfull postulates several allegedly necessary diagnostic measures ranging from ear microscopy to tympanometry to acoustic evoked response audiometry. However, he does not deliver any proof of the benefits of these recommendations—decided on the basis of a consensus. He rightly points out that no confirmed proofs exist for the treatment of sudden hearing loss. In this context, the “selective literature search” takes its revenge, so to speak: the studies by Desloovere (1, 2), which—in addition to the cited one by Klemm et al—disprove the benefits of treatment with plasma expanders, are not mentioned. It is entirely unacceptable to extract subgroups from studies with negative evidence, with the intention of deducing positive recommendations. The recommendation to offer HAES infusions—which are known for their potential to cause renal damage (3) and lifelong persistent pruritus (4, 5)—as individual health services is completely misplaced in a CME article.