Ned Calonge, MD, MPH; Diana Petitti, MD, MPH; Mary Barton, MD, MPP
Potential Conflicts of Interest: None disclosed.
Calonge N., Petitti D., Barton M.; Responses to USPSTF Guideline on Aspirin for Prevention of Cardiovascular Disease. Ann Intern Med. 2009;151:588. doi: 10.7326/0003-4819-151-8-200910200-00019
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Published: Ann Intern Med. 2009;151(8):588.
We appreciate the thoughtful letters from Dr. Budhraja and Dr. Mohan and colleagues regarding the USPSTF recommendation on aspirin prophylaxis for the prevention of cardiovascular disease. Dr. Budhraja calls attention to subgroups of women in whom the effect of aspirin in preventing cardiovascular disease may differ from that of the general population. In general, the USPSTF is cautious when considering unplanned subgroup analyses of randomized trials, which are the basis for Dr. Budhraja's comment. The authors of the original report from the Women's Health Study (1) mention multiple comparisons as an additional caution in interpreting this subgroup analysis. All subgroup analyses should be considered hypothesis-generating rather than independently persuasive.
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