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The authors’ reply:
  1. C P Gale1,
  2. S O M Manda2,
  3. B A Cattle1,
  4. C F Weston3,
  5. J S Birkhead4,
  6. P D Batin5,
  7. A S Hall6,
  8. R M West1
  1. 1
    Division of Biostatistics, University of Leeds, Leeds, UK
  2. 2
    Medical Research Council Research Unit, South Africa
  3. 3
    Swansea University, Singleton Park, Swansea, UK
  4. 4
    National Audit of Myocardial Infarction Project, National Institute for Clinical Outcomes Research, The Heart Hospital, London, UK
  5. 5
    Pinderfields General Hospital, Aberford Road, Wakefield, UK
  6. 6
    Academic Unit of Cardiovascular Medicine, The Yorkshire Heart Centre, The General Infirmary at Leeds, Leeds, UK
  1. Dr C P Gale, Division of Biostatistics, University of Leeds, Leeds LS2 9JT, UK; c.p.gale{at}

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We thank Dr Yan and colleagues for their attentive appraisal of our recent paper.1 The Myocardial Ischaemia National Audit Project (MINAP) is an extensive multicentre observational database which collects rich data on patients with acute coronary syndrome (ACS) admitted to all acute hospitals (n = 228) in England and Wales.2 Although it collects 118 data fields on over 650 000 ACS events, it does not collect precise details for some of the predictor variables used in common ACS risk scores. This is one of the weaknesses of the MINAP data: measures to overcome this constitute part of our clinical performance group research programme. As such, the dichotomisation of heart failure was beyond our control. We agree fully with Dr Yan that categorisation of data is an effortless process by which valuable information may be lost.

In response to the concerns of Dr Yan and colleagues about the manuscript’s ability to compare risk scores (through not using the coefficients derived from the original …

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  • Funding: We gratefully acknowledge funding from the British Heart Foundation.

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