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Six-month survival benefits and clinical guideline recommendations in ACS
  1. D P Chew1,
  2. F A Anderson2,
  3. Á Avezum3,
  4. K A Eagle4,
  5. G FitzGerald2,
  6. J M Gore2,
  7. R Dedrick2,
  8. D Brieger5,
  9. for the GRACE Investigators
  1. 1Flinders University, Bedford Park, Australia
  2. 2University of Massachusetts, USA
  3. 3Dante Pazzanese, Institute of Cardiology, São Paulo, Brazil
  4. 4University of Michigan, USA
  5. 5Department of Cardiology, Concord Hospital, Concord Hospital, Australia
  1. Correspondence to D P Chew Flinders Medical Centre, Flinders Drive, Bedford Park 5042, Australia; derek.chew{at}

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The Authors' reply: With thank Dr Forge for these comments1, but suspect that the findings and the purpose of our study have been over-interpreted.2 The relevance of clinical registries has been called into question. As the impact of both measured and unmeasured biases cannot be fully controlled, registries are imprecise tools for estimating the effect size of any treatment. This analysis does not seek to take precedence over randomised clinical trials. Rather, such analyses have utility in supporting existing randomised trial evidence and add to the ‘totality of data’ that informs …

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