ray ban aviator folding different designs ranging from nested case control studies in

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Leicester was the best match for two pilot sites (Nottingham and Luton). The control site for Luton is not in the same SHA but was the best match for all other criteria and was the only suitable nearest neighbour SHA. For the main impact analysis sites have been combined to provide single pilot and control sites.

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Their main point is that all studies that are retrospective ‘particularly those based on administrative databases’ are fraught with bias. Undoubtedly it is true that any study can be biased, or wrong by chance, but one has to describe what this bias would be, so each point can be individually judged for its merit. Blanket statements about bias are senseless. This is a point we dealt with over 10 years ago, when we dissected all biases that had been brought forward in a paper in the New England Journal of Medicine [1]. None held true. Since then, many more studies have come out, with very different designs, ranging from nested case control studies in the UK General Practioners’ Research Database (GPRD) [2], to cohort studies linking national databases in Denmark [3], to case control studies basd on insurance claims in managed health care plans in the United States [4], to our own population based case control studies in The Netherlands [5,6], and all have confirmed over and over again the increased risk of the abovementioned oral contraceptives over those containing levonorgestrel. In addition to epidemiological studies, laboratory studies have led to the development of methods to assess the overall haemostatic balance, by measuring the so called endogenous thrombin potential or acquired APC resistance, which predicts the risk of thrombosis in women and men [7,8].