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Editor's Correspondence |

Clinical and Ethical Questions Concerning Delirium Study on Patients With Advanced Cancer—Reply

Peter G. Lawlor, MB; Bruno Gagnon, MD; Isabelle L. Mancini, MD; Jose L. Pereira, MB; John Hanson, MSc; Maria E. Suarez-Almazor, PhD, MD; Eduardo D. Bruera, MD
Arch Intern Med. 2001;161(2):297-299. doi:.
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Although Dr Davis and Mr Walsh raise some interesting issues in their letter, they seem to have largely misinterpreted our data. Our reply will specifically address the questions on or criticisms of our data, and a more general response will address their criticisms of the purpose and conclusions of our study.

Lawlor  PGGagnon  BMancini  IL  et al.  Occurrence, causes, and outcome of delirium in advanced cancer patients: a prospective study. Arch Intern Med. 2000;160786- 794
Bruera  EFranco  JJMaltoni  MWatanabe  SSuarez-Almazor  M Changing pattern of agitated impaired mental status in patients with advanced cancer: association with cognitive monitoring, hydration, and opioid rotation. J Pain Symptom Manage. 1995;10287- 291
Lawlor  PGNeckolaichuk  CGagnon  BMancini  ILPereira  JLBruera  ED Clinical utility, factor analysis and further validation of the Memorial Delirium Assessment Scale in advanced cancer patients. Cancer. 2000;882859- 2867
Bruera  ELawlor  P Defining palliative care interventions. J Palliat Care. 1998;1423- 24
World Health Organization, Cancer Pain Relief and Palliative Care: Report of a WHO Expert Committee.  Geneva, Switzerland World Health Organization1990;World Health Organization Technical Report Series, No. 804.
Portenoy  RK Introduction: critical issues in the assessment of delirium. Portenoy  RKBruera  ETopics in Palliative Care Vol 1 New York, NY Oxford University Press Inc1997;3- 5
Bruera  EMiller  LMcCallion  JMacmillan  KKrefting  LHanson  J Cognitive failure in patients with terminal cancer: a prospective study. J Pain Symptom Manage. 1992;7192- 195
Lawlor  PGFainsinger  RLBruera  ED Delirium at the end of life: critical issues in clinical practice and research. JAMA. 2000;2842427- 2429

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