TY - JOUR T1 - Statistical compared to clinical significance and the risk of misattribution JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01723-2018 VL - 52 IS - 5 SP - 1801723 AU - Magnus Ekström AU - Miriam J. Johnson AU - David C. Currow Y1 - 2018/11/01 UR - http://erj.ersjournals.com/content/52/5/1801723.abstract N2 - We read with interest the observational analysis by Vozoris et al. [1] of the putative association between the prescription of new antidepressants (selective serotonin reuptake inhibitors (SSRIs) or serotonin-noradrenaline reuptake inhibitors (SNRIs)), and hospitalisation and mortality in people with a diagnosis of chronic obstructive pulmonary disease (COPD). In this nonrandomised analysis of administrative health data, people who got a new prescription of these antidepressants faced a worse prognosis including a 26% increase in pneumonia-related mortality and a 20% higher risk of death from all causes [1]. This analysis used similar methodology as previous papers on benzodiazepines and opioids and shares the same important shortcomings [2, 3].Observational analyses of putative drug effects, including a recent on antidepressants and increased mortality in COPD, may be biased, should be interpreted sceptically and often need to be confirmed by randomised data to change practice. http://ow.ly/oh5030m9Q9I ER -