BMJ  2005;330:601 (12 March), doi:10.1136/bmj.330.7491.601-a

Letter

Screening for abdominal aortic aneurysm

Screening reduces deaths related to aneurysm

The first 150 words of the full text of this article appear below.

EDITOR—The Australian randomised trial of aortic aneurysm screening observed 18 deaths related to aneurysm in the group of men invited for screening and 25 in the control group.1 The corresponding reduction in mortality was 39% (relative risk 0.61, 95% confidence interval 0.33 to 1.11), which the authors summarise as showing that screening did not reduce overall death rates. The authors have fallen into the common trap of interpreting a non-significant difference as evidence of no difference.

The stated conclusion is all the more surprising given the available evidence from other randomised trials (table). In each trial, the number of aneurysm related deaths in the men invited for screening is lower than in the control group, and so the relative risks are all below 1. The widths of the confidence intervals vary according to the size and power of the trial. The largest trial, the multicentre aneurysm . . . [Full text of this article]

Simon Thompson, director

simon.thompson@mrc-bsu.cam.ac.uk, MRC Biostatistics Unit, Cambridge CB2 2SR

Lois Kim, statistician

MRC Biostatistics Unit, Cambridge CB2 2SR

Alan Scott, research director

Scott Research Unit, St Richard's Hospital, Chichester PO19 4SE


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Relevant Article

Population based randomised controlled trial on impact of screening on mortality from abdominal aortic aneurysm
Paul E Norman, Konrad Jamrozik, Michael M Lawrence-Brown, Max T Q Le, Carole A Spencer, Raywin J Tuohy, Richard W Parsons, and James A Dickinson
BMJ 2004 329: 1259. [Abstract] [Full Text] [PDF]




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