To the Editor The Original Investigation by Reinhardt et al1 that was published in a recent issue of JAMA Internal Medicine used publicly available data from the National Institutes of Health–funded Rule Out Myocardial Infarction Using Computed Assisted Tomography (ROMICAT) II Trial (NCT01084239). The premise of this post hoc analysis was to compare process and health outcomes between patients who did and did not receive risk stratification beyond the initial emergency department (ED) evaluation. Reinhardt et al1 stated that patients without further testing have similar outcomes compared with those who did and concluded that further testing was not useful. We, on behalf of the original ROMICAT II investigators, strongly disagree.
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Hoffmann U, Ferencik M, Udelson J. Incorrect Conclusions of a Secondary Analysis. JAMA Intern Med. 2018;178(4):581–582. doi:10.1001/jamainternmed.2018.0212
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