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[Correspondence] Inhaled triple therapy in chronic obstructive pulmonary disease

Alberto Papi and colleagues1 reported that in 1532 patients with a history of exacerbation, triple therapy significantly reduced the exacerbation rate by 15% compared to double bronchodilation, without changing the individual patient risk of having at least one exacerbation. This statistical significance should be interpreted cautiously. Considering the relatively large difference in exacerbation rate and the large number of patients, a p value of 0·043 could be explained by differences in the distribution of exacerbations per patient.