Anesthetic Exposure and Academic Achievement: Missing the Forest for the Trees

摘要

I read with interest the recent report from Block et al., examining the relation between anesthetic exposure in the first year of life and academic achievement, but have concerns that their analysis inappropriately emphasizes the post hoc observation of an excess of subjects with extremely low achievement scores rather than overall academic achievements. The authors do not explicitly state their Null (Alternative) Hypotheses; however, based on the title of their report and its Introduction, I suspect that they were of the form "the distribution of achievement test scores in children exposed to anesthesia before age 1 yr does not (does) differ from that seen in children not so exposed." The analysis presented by the authors would be appropriate only to the far more specific Null (Alternative) Hypotheses that "children exposed to anesthesia before 1 yr of age are not (are) more likely to score in the lowest fifth percentile on tests of academic achievement." The authors' analysis unnecessarily discards almost all the informations available from the distribution of scores.