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Correspondence re: M Monaghan et al. Pediatric Lyme disease: systematic assessment of post-treatment symptoms and quality of life

Pediatric Research volume 95, page 2 (2024)Cite this article

As a physician working with children and adolescents, I read with great interest the article by Monaghan et al. Pediatric Lyme disease: systematic assessment of post-treatment symptoms and quality of life. Pediatric Research, 2023.1 In it, the authors conclude that their “…findings have important implications for clinicians treating children with Lyme disease (LD). Families should be counseled that full recovery is expected.” “Further, in a small percentage with prolonged symptoms with or without impact on functioning, full recovery will likely eventually be achieved.” Unfortunately, this conclusion may be over-stated based on several study limitations.

The analytic sample is a small proportion of the target eligible population (102 or 25% of 402 eligible individuals), with respondents differing from non-respondents in terms of symptoms/stage at original diagnosis and racial group, with meaningful difference in number of Black individuals in each group. These factors could have resulted in misclassification due to differential response bias, with non-respondents having more persistent symptoms than respondents, leading to an underestimate of the true rate in the population. Additionally, the analyses done by the authors do not include multivariable analyses to attempt to control for potential confounding by factors like race, sex, presentation, or adequacy of therapy. It may be that the sample studied was too small for these analyses, but this limits interpretation of the results.

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References

  1. Monaghan M. et al. Pediatric Lyme disease: systematic assessment of post-treatment symptoms and quality of life. Pediatr. Res. https://doi.org/10.1038/s41390-023-02577-3 (2023).

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  1. Medical Arts Psychotherapy Assoc. PA, 33 Overlook Road Suite 406, New Jersey, 07901, Summit, USA

    Rosalie Greenberg

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  1. Rosalie Greenberg
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Correspondence to Rosalie Greenberg.

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Greenberg, R. Correspondence re: M Monaghan et al. Pediatric Lyme disease: systematic assessment of post-treatment symptoms and quality of life. Pediatr Res 95, 2 (2024). https://doi.org/10.1038/s41390-023-02720-0

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