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Correspondence
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Volume 358:2641-2644 June 12, 2008 Number 24
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Drug-Eluting Stents vs. Coronary-Artery Bypass Grafting

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 by Hannan, E. L.
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To the Editor: Hannan et al. (Jan. 24 issue)1 are to be commended for appropriately selecting patients with multivessel coronary disease for stenting or bypass surgery. Their clinical judgment ensured that unadjusted survival rates were equal in the two groups, even among patients with diabetes.

The authors attempt to equalize the two groups by evaluating risk-adjusted survival. However, they endeavor to adjust an unadjustable characteristic — the judgment of the treating physician, which is uncorrectable by adjusting for simple clinical variables. Although propensity analyses are valuable in assessing differences between groups, propensity-score matching might have been more enlightening.2

Meta-analyses of . . . [Full Text of this Article]


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