We read with interest the recent publication regarding Cycas exposures and would like to raise some concerns [ 1 ]. Retrospective analyses of poison center data are inherently flawed and their misinterpretation may confound the risk assessment and management of truly poisoned patients [ 2 ]. Given that all 192 cases were self-reported, there is considerable concern for incorrect self-identification of exact genus and species of exposure. Additionally, there was no confirmatory testing or expert opinion to support that these patients were actually exposed to Cycas. The fact that 19.6% of patients could not identify the ingested plant part(s), 2 patients with reported exposure had an unknown gender, and the complete failure to distinguish acute from chronic exposures raises further concerns about the quality of the data. While the authors generated multiple “statistically significant” results by comparing the characteristics of reported ingestions to reported inhalation exposures, the clinical significance of these comparisons is deeply questionable ...
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", language="en", issn="0735-6757", doi="10.1016/j.ajem.2019.12.033", url="http://dx.doi.org/10.1016/j.ajem.2019.12.033" }