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June 19, 2002

Estimating Treatment Effects From Observational Data: Dissonant and Resonant Notes From the SYMPHONY Trials

Author Affiliations

Author Affiliations: Department of Epidemiology, Harvard School of Public Health (Dr Michels); Obstetrics and Gynecology Epidemiology Center (Dr Michels), and Department of Medicine (Drs Michels and Braunwald), Brigham and Women's Hospital, Harvard Medical School, Boston, Mass.

JAMA. 2002;287(23):3130-3132. doi:10.1001/jama.287.23.3130

Can observational data substitute for randomized controlled trials for developing treatment recommendations and initiating public health interventions? This question arises from the article by Newby and colleagues1 on the early initiation of statins in patients with acute coronary syndromes (ACS), reported in this issue of THE JOURNAL. The authors present results from an observational cohort study that indicate no difference in mortality and cardiovascular outcomes among patients with ACS who initiated statin treatment prior to hospital discharge and patients who did not receive statins.