In our comment on the study of non-invasive ventilation (NIV) in patients with amyotrophic lateral sclerosis by Bourke and colleagues, we stated that a "shortcoming of this study lies in the fact that 51 patients enrolled in the study eventually did not participate in the trial". We thank the authors for pointing out that all 92 patients enrolled in the study were closely followed. The 51 patients had less rapid disease progression and did not meet the criteria for randomisation during the study period. We did not pick up on this in the paper, because the characteristics of the patients that were not randomly assigned were not given. Patients with a more protracted disease course, who could not be included, in the intervention part ofthe study, might be more likely to benefit from NIV, and the effect of NIV on survival as found in the trial may be underestimated when applied to all patients with amyotrophic lateral sclerosis.
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