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J Thorac Cardiovasc Surg 2008;135:460
© 2008 The American Association for Thoracic Surgery

Letter to the Editor

Reply to the Editor

Endre Bodnar, MDa, Eugene H. Blackstone, MDb

a Editor in Chief, The Journal of Heart Valve Disease, Northwood, UK
b Cleveland Clinic, Cleveland, Ohio

The first 20% of the full text of this article appears below.

We are gratified by Dr Anderson’s solid endorsement of our editorial, helping to clarify this rather confused and confusing situation surrounding the use of the word "actual" in the assessment of intrinsic valve performances. We fully agree with him regarding the importance of the concept of competing risks environment. His proposals on reporting long-term experiences with replacement heart valves are excellent, and we recommend that future authors follow his advice.

The letter by Grunkemeier, Takkenberg, and Jamieson incorrectly summarizes in its first paragraph the content of our editorial and therefore adds unnecessary confusion. Dr Bodnar was probably the first to introduce competing risks to cardiac surgery; Dr Blackstone and colleagues have used competing risks analyses extensively in multiple settings of adult and, particularly, congenital heart disease, and both will continue to do so to answer questions that methodology was designed to answer. The method is not the problem! The problem is its inappropriate use in answering questions related to intrinsic properties of heart valve substitutes, such as comparative durability. From its beginning, our editorial was clear about the specific, focused context of our remarks. Rather than restate the entire editorial to make 1 . . . [Full Text of this Article]


Related Articles

Comment on the "actual" problem editorial
William N. Anderson
J. Thorac. Cardiovasc. Surg. 2008 135: 457-459. [Extract] [Full Text] [PDF]

Reporting "actual freedom" should not be banned
Gary L. Grunkemeier, Johanna J.M. Takkenberg, W.R. Eric Jamieson, and D. Craig Miller
J. Thorac. Cardiovasc. Surg. 2008 135: 460-462. [Extract] [Full Text] [PDF]





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