Ellipsis marks an important omission

Gornall, in his article about the paper by Carpenter et al on recurrent infant deaths,¹ was right to argue that uncertain data should not be translated into statistics that seem clear cut. But his suggestion that a report by John Emery, the pathologist who initiated the Lancet study, upheld the ultra-suspiciousness of “Meadow's law” is curious.

Emery produced the report for Sally Clark's defence in 1999, six months before his death.² He wrote that in families where there were two cot deaths, a third were due to rare natural causes that had been missed at autopsy, and a third were unnatural deaths associated with abuse. The final third were “true” sudden infant death syndrome (SIDS) in that “no suspicion of unnatural death was found and no natural cause was found.”

Although Emery's words make it clear that no basis for suspicion was found in two thirds of recurrent deaths, Gornall writes that Emery reached a “stark” conclusion which he purports to quote: “The occurrence of two unexpected deaths in a family thus raises a definite suspicion of unnatural death which in my experience is confirmed ... in a third of such cases.”

The ellipsis is odd. What has Gornall left out? If we check Emery's report we find it was a single word. This is what the sentence said before Gornall edited it: “The occurrence of two unexpected deaths in a family thus raises a definite suspicion of unnatural death which in my experience is confirmed only in a third of such cases.”

By omitting the word “only” Gornall changes the emphasis of the entire quotation. Whereas the original implies reservations about Meadow's law, Gornall has adjusted the sense so that he can recruit Emery's conclusion in support of this law.

It is important that medical papers should categorise and report their results scrupulously. But those who seek to criticise them should show an equal degree of scrupulousness.