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October 14, 1998

Outcomes After Carotid Endarterectomy—Reply

Author Affiliations

Margaret A.WinkerMD, Senior EditorIndividualAuthorPhil B.FontanarosaMD, Senior EditorIndividualAuthor


Copyright 1998 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1998

JAMA. 1998;280(14):1228-1229. doi:10-1001/pubs.JAMA-ISSN-0098-7484-280-14-jbk1014

In Reply.—Application of the results of randomized controlled trials (RCTs) to individual patients without a critical assessment of which patients were enrolled and who the physicians or institutions were can lead to inappropriate clinical decisions. In our study of carotid endarterectomy, we found that patients in RCTs had substantially lower mortality than patients at the same centers who were treated outside the randomized trials. We also found that the providers participating in the RCTs had better performance than those who did not participate in the trials.

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