To the Editor The development of large administrative databases has provided a convenient potential tool to allow rapid discoveries and improvements in health care. Dr Pincus and colleagues1 used such a database from Ontario to assess outcomes after hip fracture surgery. They adjusted their estimates for many confounders using data from electronic discharge abstracts. Although caveats about observational studies were cited in the article, potential exacerbating factors were not mentioned, which may be problematic given the small difference between the 2 groups and the use of admission-to-surgery times (rather than fracture-to-surgery times).
Haviari S. Wait Time for Hip Fracture Surgery and Mortality. JAMA. 2018;319(21):2234. doi:10.1001/jama.2018.4422
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