To the Editor We read with interest the Original Investigation by Graham et al1 in a recent issue of JAMA Internal Medicine comparing treatment-related benefits and risks among elderly Medicare beneficiaries who were treated with dabigatran or rivaroxaban for nonvalvular atrial fibrillation (AF).1 Disconcertingly, the study found substantially higher risks of intracranial hemorrhage and major extracranial bleeding with use of rivaroxaban than dabigatran, with significantly increased mortality in patients 75 years or older.