The flaws in the detail of an observational study on transcatheter aortic valve implantation versus surgical aortic valve replacement in intermediate-risks patients
| العنوان: | The flaws in the detail of an observational study on transcatheter aortic valve implantation versus surgical aortic valve replacement in intermediate-risks patients |
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| المؤلفون: | Andreas Böning, Nick Freemantle, Piotr Suwalski, Rafael Sadaba, Volkmar Falk, Miguel Sousa-Uva, Nawwar Al-Attar, Thierry Folliguet, Jean-François Obadia, Claudio Muneretto, Lorenzo Menicanti, Jolanda Kluin, Roberto Lorusso, Martin Czerny, Pieter Kappetein, Prakash P Punjabi, Fabio Barili, Umberto Benedetto, Nikolaos Bonaros, Michele De Bonis |
| المساهمون: | Barili, Fabio, Freemantle, Nick, Folliguet, Thierry, Muneretto, Claudio, DE BONIS, Michele, Czerny, Martin, Obadia, Jean Francoi, Al attar, Nawwar, Bonaros, Nikolao, Kluin, Jolanda, Lorusso, Roberto, Punjabi, Prakash, Sadaba, Rafael, Suwalski, Piotr, Benedetto, Umberto, Böning, Andrea, Falk, Volkmar, Sousa uva, Miguel, Kappetein, Pieter A, Menicanti, Lorenzo, Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Cardiothoracic Surgery, Amsterdam Cardiovascular Sciences, ACS - Heart failure & arrhythmias, ACS - Atherosclerosis & ischemic syndromes, CTC, RS: CARIM - R2.12 - Surgical intervention, MUMC+: MA Med Staf Spec CTC (9) |
| المصدر: | Barili, F, Freemantle, N, Folliguet, T, Muneretto, C, Bonis, M D, Czerny, M, Obadia, J F, Al-Attar, N, Bonaros, N, Kluin, J, Lorusso, R, Punjabi, P, Sadaba, R, Suwalski, P, Benedetto, U, Böning, A, Falk, V, Sousa-Uva, M, Kappetein, P A & Menicanti, L 2017, ' The flaws in the detail of an observational study on transcatheter aortic valve implantation versus surgical aortic valve replacement in intermediate-risks patients ', European Journal of Cardio-Thoracic Surgery, vol. 51, no. 6, pp. 1031-1035 . https://doi.org/10.1093/ejcts/ezx058Test European Journal of Cardio-Thoracic Surgery European Journal of Cardio-Thoracic Surgery, Oxford University Press (OUP), 2017, 51 (6), pp.1031--1035. ⟨10.1093/ejcts/ezx058⟩ European Journal of Cardio-thoracic Surgery, 51(6), 1031-1035. Elsevier European journal of cardio-thoracic surgery, 51(6), 1031-1035. Elsevier European Journal of Cardio-Thoracic Surgery, 51(6), 1031-1035. Oxford University Press |
| بيانات النشر: | OXFORD UNIV PRESS INC, 2017. |
| سنة النشر: | 2017 |
| مصطلحات موضوعية: | Aortic valve, SURGERY, [SDV]Life Sciences [q-bio], 030204 cardiovascular system & hematology, Aortic valve replacement, Propensity score analysis, Statistical analysis, Transcatheter valve therapy, Valve disease, Aortic Valve, Aortic Valve Stenosis, Heart Valve Prosthesis Implantation, Humans, Propensity Score, Reproducibility of Results, Research Design, Risk Factors, Transcatheter Aortic Valve Replacement, 0302 clinical medicine, EUROSCORE, OUTCOMES, Ejection fraction, SCORES, General Medicine, 3. Good health, medicine.anatomical_structure, Aortic valve stenosis, RELIABILITY, Cardiology, Cardiology and Cardiovascular Medicine, Pulmonary and Respiratory Medicine, medicine.medical_specialty, SOCIETY, Statistical analysi, STENOSIS, Propensity score analysi, 03 medical and health sciences, Internal medicine, medicine, METAANALYSIS, Mitral regurgitation, business.industry, MORTALITY, EuroSCORE, medicine.disease, MITRAL REGURGITATION, Surgery, 030228 respiratory system, Propensity score matching, Observational study, business |
| الوصف: | International audience; The PARTNER group recently published a comparison between the latest generation SAPIEN 3 transcatheter aortic valve implantation (TAVI) system (Edwards Lifesciences, Irvine, CA, USA) and surgical aortic valve replacement (SAVR) in intermediate-risk patients, apparently demonstrating superiority of the TAVI and suggesting that TAVI might be the preferred treatment method in this risk class of patients. Nonetheless, assessment of the non-randomized methodology used in this comparison reveals challenges that should be addressed in order to elucidate the validity of the results. The study by Thourani and colleagues showed several major methodological concerns: suboptimal methods in propensity score analysis with evident misspecification of the propensity scores (PS; no adjustment for the most significantly different covariates: left ventricular ejection fraction, moderate-severe mitral regurgitation and associated procedures); use of PS quintiles rather than matching; inference on not-adjusted Kaplan-Meier curves, although the authors correctly claimed for the need of balancing score adjusting for confounding factors in order to have unbiased estimates of the treatment effect; evidence of poor fit; lack of data on valve-related death. These methodological flaws invalidate direct comparison between treatments and cannot support authors' conclusions that TAVI with SAPIEN 3 in intermediate-risk patients is superior to surgery and might be the preferred treatment alternative to surgery. |
| وصف الملف: | application/pdf |
| اللغة: | English |
| تدمد: | 1010-7940 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f09c768ac36dc0f5a040a2778eb10f83Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f09c768ac36dc0f5a040a2778eb10f83 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 10107940 |
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