To the Editor: The study by Ayanian and Epstein (July 25 issue)1 suggests that sex bias affects physicians' decisions about patients with suspected or confirmed coronary artery disease. However, other possible interpretations of its results deserve further discussion. It may be that the observed differences between the sexes in the rates of cardiac catheterization and revascularization procedures were due to confounding bias. Although the investigators controlled for some potential confounding variables, they did not consider many seemingly important ones. They collected no information about many aspects of the severity of the patients' coronary artery disease, such as the severity of. . .
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