Neutze J M, White H D
Br Med J (Clin Res Ed). 1987 Feb 14;294(6569):405-9. doi: 10.1136/bmj.294.6569.405.
The number of deaths from coronary artery disease is declining in New Zealand as in some other Western countries. It has been estimated that in 1981 in the Auckland metropolitan area there were 126 fewer deaths than would have been expected from the data in 1974. The contribution made by cardiac surgery to this decline was assessed from the known numbers of patients who were operated on, from their survival rate, and from the predicted mortality of the surgical cohort had they not undergone operation. Such mortality was predicted from past studies of patients with similar symptoms, exercise data, studies of unstable angina, and the coronary artery surgical study registry. From this method it was estimated that coronary surgery accounted for 26% to 42% of the reduction in coronary deaths. Two previous studies estimated, from calculations based on the European study of patients with modest symptoms, that the contribution of cardiac surgery was much lower. Extrapolating data from one subset of patients to a second subset with quite different characteristics is a conceptual fallacy.
与其他一些西方国家一样，新西兰冠状动脉疾病的死亡人数正在下降。据估计，1981年奥克兰都会区的死亡人数比根据1974年数据预期的死亡人数少126人。心脏手术对这种下降的贡献是根据已知的手术患者数量、他们的存活率以及如果他们没有接受手术，该手术队列的预测死亡率来评估的。这种死亡率是根据过去对有类似症状患者的研究、运动数据、不稳定型心绞痛研究以及冠状动脉外科研究登记处的数据预测的。通过这种方法估计，冠状动脉手术占冠状动脉死亡人数减少的26%至42%。之前的两项研究根据对症状较轻患者的欧洲研究计算得出，心脏手术的贡献要低得多。将一组患者的数据外推到具有截然不同特征的另一组患者是一种概念上的谬误。
