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Research Letter
November 20, 2013

Subgroup Analyses in Trial Reports Comparing Percutaneous Coronary Intervention With Coronary Artery Bypass Surgery

Author Affiliations
  • 1Department of Cardio-Thoracic Surgery, Erasmus University Medical Center, Rotterdam, the Netherlands
  • 2Division of Cardiology, Cedars-Sinai Medical Center, Los Angeles, California
  • 3Department of Cardiology, Academic Medical Center of the University of Amsterdam, Amsterdam, the Netherlands
  • 4Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands
JAMA. 2013;310(19):2097-2098. doi:10.1001/jama.2013.281630

Subgroup analyses within randomized clinical trials (RCTs) may not be valid,1,2 although they may identify important treatment heterogeneity. Reviews of subgroup analyses in primary reports of RCTs have found low credibility due to methodological or reporting issues.2 Subgroup analyses may also be presented in separate reports of extended follow-up beyond the primary end point or specific subgroups of patients.

No data are available on the quality of subgroup analyses in these subsequent reports. We evaluated subgroup analyses in reports from RCTs comparing percutaneous coronary intervention (PCI) with coronary artery bypass grafting (CABG).

PubMed was searched up to January 1, 2011, to identify primary end point reports of RCTs comparing PCI with CABG for complex coronary artery disease using the following search: “(PCI OR PTCA OR percutaneous coronary intervention) AND (CABG OR coronary bypass) AND (random*).” A second search through January 1, 2012, identified subsequent reports of extended follow-up beyond the primary end point or subgroups of patients (eg, patients with diabetes).

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