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Rios et al¹ identified a statistically significant association between the HLA-Cw4 allele and multinodular goiters (15.5% vs 8.3%; P = .001; relative risk = 0.49). This finding was based on a comparison of 90 surgical patients with multinodular goiters from a single institution with a control group of 100 unrelated, healthy blood donors "representative of the healthy population."

Representativeness of the normal population would imply that just 50% of these blood donors serving as controls were female, which contrasts with the stated 92% (83/90) of female patients with multinodular goiters. As women are known to develop multinodular goiters more often than men, the excess in female patients with multinodular goiters alone may have caused a spurious significant association.

A similar divide between the 2 groups may have existed with regard to patient age. The patients with multinodular goiter were aged 49±13 (mean±SD) years on average, but the age characteristics of their blood donor . . . [Full Text of this Article]

AUTHOR INFORMATION
Andreas Machens, MD; Henning Dralle, MD

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