Rhode Island Office of State Medical Examiners

For better data on SIDS

I appreciate the Scripps-Howard News Service articles regarding Sudden Infant Death Syndrome (SIDS) and the attention The Journal has brought to this tragic and challenging medical problem by publishing these articles on Oct. 21. As the lead article — “Why did these babies die? Changes in reporting have altered statistics on SIDS deaths, but the mystery remains” — correctly implies, there has been significant variation in the criteria used to diagnose SIDS. There are many reasons for this variation, some of which represent an evolution in thinking based on research and others that represent a failure to promulgate standards for national practice. The latter has resulted in significant regional variation in the diagnosis of SIDS, as the articles note.

To address this lack of standardization, the federal Centers for Disease Control and Preventionhas developed a framework in which consistent investigations into sudden unexplained infant deaths may be conducted. Additionally, the CDC has conducted training across the country in an effort to standardize procedure.

I was fortunate enough to participate in such training with a team from Rhode Island that represented various groups involved in the investigation of infant deaths. As of Sept. 1, we have introduced a protocol for infant-death investigations in Rhode Island that is in compliance with the CDC’s standards. This introduction followed efforts involving the Office of the State Medical Examiner, Rhode Island Department of Health, all local and state law-enforcement jurisdictions, the Department of Children, Youth and Families and Brown University.

Part of the difficulty in coming to an understanding of the disease or diseases responsible for infant deaths has been the lack of standardization cited in the articles. I hope that our data from Rhode Island, along with national data, using the proposed CDC standards will result in data that can be used to prevent these deaths.

THOMAS GILSON, M.D.