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"textoCompleto" => "<p class="elsevierStylePara">Dear Editor:</p><p class="elsevierStylePara">In a recent letter titled “A discussion on quality”<span class="elsevierStyleSup">1</span> the author states that “in order to demonstrate the virtues of the quality indicators, some of the articles use very weak baseline data”.<span class="elsevierStyleSup">2,3</span> We feel that this hypothesis could easily be refuted with objective data. We will compare variables from the clinical results of the observational study titled <span class="elsevierStyleItalic">Dialysis Outcomes</span> and <span class="elsevierStyleItalic">Practice Pattern Study</span> (DOPPS),<span class="elsevierStyleSup">4</span> which included 575 patients from 20 different centres in Spain, with the baseline results of our study (313 patients from four centres)<span class="elsevierStyleSup">2</span>:mean haemoglobin 10.8 <span class="elsevierStyleItalic">vs</span>. 11.7 ± 1.4g/dl, phosphorus 5.5 <span class="elsevierStyleItalic">vs</span> 5.3 ± 1.6mg/dl, Kt/Vsp 1.31 <span class="elsevierStyleItalic">vs</span>. 1.37 ± 0.29, ferritin 288 <span class="elsevierStyleItalic">vs</span>. 370 ± 290mg/ml and percentage of autologous arteriovenous fistulas 81 <span class="elsevierStyleItalic">vs</span>. 79.9 (DOPPS vs. our own study)<span class="elsevierStyleSup">2</span> (the standard deviation for the DOPPS study is not mentioned because it does not appear in the publication). After seeing the results from both studies, we can state that variables from the clinical results of the DOPPS study could be considered worse than, or at best similar to, those presented by the patients in our study. The conclusion that we reach is not different when we analyse the European population (excluding Spain), which is also represented in the DOPPS study. The comparison with the study carried out by Plantinga et al. is more complex due to the form in which the results are expressed, but in general, although these results are worse than the Spanish and European results, they are similar to those from the rest of the population of the United States. Comparisons of variables from clinical results in centres should be carried out with representative samples from the general population, and not with samples representing select centres. The author does not mention what studies the cited studies are compared with. As Fink et al. describe, the variability of results from centre to centre is welldemonstrated (they call this phenomenon the “centre effect”).<span class="elsevierStyleSup">5</span> We heartily agree with the other statements expressed in the letter. Meanwhile, we confirm the limitations of our study (which were not mentioned by the writer of the letter) which were listed in the original publication.</p>"
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