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Volume 358:2644-2645 June 12, 2008 Number 24
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Endovascular vs. Open Repair of Abdominal Aortic Aneurysms

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 by Schermerhorn, M. L.
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To the Editor: Schermerhorn and colleagues (Jan. 31 issue)1 examined the relative effectiveness of endovascular versus open repair of abdominal aortic aneurysms. They used a propensity-score approach to match the open-repair and endovascular-repair groups according to demographic and clinical factors. They argued strongly that unmeasured confounding factors were unlikely to bias their results. Unfortunately, propensity scores do not eliminate bias if there are unmeasured confounders.2 The story of the pulmonary-artery catheter provides a cautionary tale. Using a propensity score, investigators found that the use of a pulmonary-artery catheter was associated with a 24% increase in the risk of death as . . . [Full Text of this Article]




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