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European Heart Journal Advance Access originally published online on June 19, 2006
European Heart Journal 2006 27(14):1642-1643; doi:10.1093/eurheartj/ehl111
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© The European Society of Cardiology 2006. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Limitations of analyses of effectiveness using observational data

Barnaby C. Reeves*

Bristol Heart Institute, Clinical Science South Bristol, Level 7, Bristol Royal Infirmary, Marlborough Street, Bristol, UK

* Corresponding author. Tel: +44 117 928 3143; fax: +44 117 929 9737. E-mail address: barney.reeves@bristol.ac.uk

This editorial refers to ‘Quality of life after coronary revascularization in the elderly’{dagger} by M.M. Graham et al., on page 1690

The first 10% of the full text of this article appears below.

Graham and colleagues report health-related quality of life (HRQoL) in a cohort of patients 1 and 3 years after undergoing cardiac catheterization.1 The paper focuses on differences in HRQoL between groups of elderly patients (all >70 years of age) who were subsequently revascularized and those who received medication only. The former had consistently better HRQoL at both times, with a tendency for patients who had bypass surgery to report better health than those who had percutaneous intervention. The paper contributes to the growing literature suggesting that coronary revascularization is under-used,2–4 although it remains uncertain whether under-use arises because revascularization is withheld or refused.

Increasing priority is being placed on estimating the effectiveness of interventions using outcomes that directly reflect patients' perceptions of the value of treatment (i.e. the . . . [Full Text of this Article]


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Related articles in EHJ:

Quality of life after coronary revascularization in the elderly
Michelle M. Graham, Colleen M. Norris, P. Diane Galbraith, Merril L. Knudtson, William A. Ghali, and for the APPROACH Investigators
EHJ 2006 27: 1690-1698. [Abstract] [Full Text]