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Previous Volume 334:56-57 January 4, 1996 Number 1 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text Purchase this article Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited Related Article by Konstantinides, S.

To the Editor: In the August 24 issue of the Journal,¹ Konstantinides et al. describe a nonrandomized study of two treatment strategies for adults with atrial septal defect. The authors conclude that the surgical closure of atrial septal defects in patients over 40 years of age improves long-term survival, and an accompanying editorial supports this view.²

The limitations of nonrandomized studies have been recognized for many years, and such studies require cautious interpretation, particularly because the possibility of treatment-assignment bias cannot be excluded.³ Konstantinides et al. provide little information about the selection of patients for surgery, although in their study . . . [Full Text of this Article]

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