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Drug Safety

, Volume 41, Issue 5, pp 541–543 | Cite as

Authors’ reply: Safety of Human Papillomavirus Vaccines

  • Kristine Macartney
  • Anastasia Phillips
  • Cyra Patel
  • Alexis Pillsbury
  • Julia Brotherton
Letter to the Editor
  • 216 Downloads

We strongly disagree with the assertions made by Chandler et al. [1] and Martinez-Lavin [2] regarding our use of evidence [3] and with the validity of the alternative information presented by the authors.

Chandler et al. [1] contend that a hierarchy of evidence is outdated and that we use epidemiological evidence to “trump” the findings of case reports and case series. The evidence hierarchy used to structure our review is a globally accepted paradigm in modern clinical medicine and healthcare [4]. Modifications to this hierarchy routinely place case series and case reports as the lowest level of evidence [5], reflecting their high risk of bias. We note that both Chandler et al. [1] and Martinez-Lavin [2] cite multiple very small and largely observational studies with no controls, several of which have been criticized [6, 7]. This is despite Martinez-Lavin [2] questioning the validity of “small” clinical trials.

The vast majority of evidence-based reviews on any topic do not include...

Notes

Compliance with Ethical Standards

Funding

No sources of funding were used to assist in the preparation of this study.

Conflicts of interest

Kristine Macartney, Anastasia Phillips, Alexis Pillsbury and Cyra Patel have no conflicts of interest that are directly relevant to the content of this study. Julia Brotherton is employed as the Director of the National HPV Vaccination Program Register, which is owned and funded by the Australian Government Department of Health. She has been an investigator on investigator-initiated HPV epidemiology studies that have received unrestricted partial funding for laboratory components from Seqirus (cervical cancer typing study) and Merck (recurrent respiratory papillomatosis study) but has never received any personal financial benefits.

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Kristine Macartney
    • 1
    • 2
  • Anastasia Phillips
    • 1
  • Cyra Patel
    • 2
  • Alexis Pillsbury
    • 2
  • Julia Brotherton
    • 3
    • 4
  1. 1.The University of SydneySydneyAustralia
  2. 2.National Centre for Immunisation Research and Surveillance, Kids Research Institute, The Sydney Children’s Hospitals NetworkWestmeadAustralia
  3. 3.National HPV Vaccination Program Register, Victorian Cytology ServiceEast MelbourneAustralia
  4. 4.The University of MelbourneMelbourneAustralia

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