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Comparison of predictions based on observational data with the results of randomized controlled clinical trials of coronary artery bypass surgery.

Publication ,  Journal Article
Hlatky, MA; Califf, RM; Harrell, FE; Lee, KL; Mark, DB; Pryor, DB
Published in: J Am Coll Cardiol
February 1988

Clinical decisions are most secure when based on findings from several large randomized clinical trials, but relevant randomized trial data are often unavailable. Analyses using clinical data bases might provide useful information if statistical methods can adequately correct for the lack of randomization. To test this approach, the findings of the three major randomized trials of coronary bypass surgery were compared with predictions of multivariable statistical models derived from observations in the Duke Cardiovascular Disease Databank. Clinical characteristics of patients at Duke University Medical Center who met eligibility requirements for each major randomized trial were used in the models to predict 5 year survival rates expected for medical and surgical therapy in each randomized trial. Model predictions agreed well with randomized trial results and were within the 95% confidence limits of the observed survival rates in 24 (92%) of 26 clinical subgroups. The overall correlation between predicted and observed survival rates was good (Spearman coefficient 0.73, p less than 0.0001). These results suggest that carefully performed analyses of observational data can complement the results of randomized trials.

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Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

February 1988

Volume

11

Issue

2

Start / End Page

237 / 245

Location

United States

Related Subject Headings

  • Random Allocation
  • Prognosis
  • Probability
  • Models, Biological
  • Middle Aged
  • Male
  • Humans
  • Female
  • Coronary Disease
  • Coronary Artery Bypass
 

Citation

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Hlatky, M. A., Califf, R. M., Harrell, F. E., Lee, K. L., Mark, D. B., & Pryor, D. B. (1988). Comparison of predictions based on observational data with the results of randomized controlled clinical trials of coronary artery bypass surgery. J Am Coll Cardiol, 11(2), 237–245. https://doi.org/10.1016/0735-1097(88)90086-1
Hlatky, M. A., R. M. Califf, F. E. Harrell, K. L. Lee, D. B. Mark, and D. B. Pryor. “Comparison of predictions based on observational data with the results of randomized controlled clinical trials of coronary artery bypass surgery.J Am Coll Cardiol 11, no. 2 (February 1988): 237–45. https://doi.org/10.1016/0735-1097(88)90086-1.
Hlatky MA, Califf RM, Harrell FE, Lee KL, Mark DB, Pryor DB. Comparison of predictions based on observational data with the results of randomized controlled clinical trials of coronary artery bypass surgery. J Am Coll Cardiol. 1988 Feb;11(2):237–45.
Hlatky, M. A., et al. “Comparison of predictions based on observational data with the results of randomized controlled clinical trials of coronary artery bypass surgery.J Am Coll Cardiol, vol. 11, no. 2, Feb. 1988, pp. 237–45. Pubmed, doi:10.1016/0735-1097(88)90086-1.
Hlatky MA, Califf RM, Harrell FE, Lee KL, Mark DB, Pryor DB. Comparison of predictions based on observational data with the results of randomized controlled clinical trials of coronary artery bypass surgery. J Am Coll Cardiol. 1988 Feb;11(2):237–245.
Journal cover image

Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

February 1988

Volume

11

Issue

2

Start / End Page

237 / 245

Location

United States

Related Subject Headings

  • Random Allocation
  • Prognosis
  • Probability
  • Models, Biological
  • Middle Aged
  • Male
  • Humans
  • Female
  • Coronary Disease
  • Coronary Artery Bypass