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Righteous indignation versus misplaced frustration: p values, CIs, effect sizes and the CASTLE-AF trial
  1. Martin Mayer1,2
  1. 1 Innovations and Evidence-Based Medicine Development, EBSCO Health|EBSCO Information Services, Ipswich, Massachusetts, USA
  2. 2 East Carolina Heart Institute, General Medicine Service, Vidant Medical Center, Greenville, North Carolina, USA
  1. Correspondence to Dr Martin Mayer; mmayer{at}

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The misplaced frustration in Sierra and colleagues’ recently published letter1 left me perplexed.

They target the primary composite outcome (PCO) in the Catheter Ablation versus Standard Conventional Therapy in Patients with Left Ventricular Dysfunction and Atrial Fibrillation (CASTLE-AF) trial, noting the PCO of all-cause mortality or hospitalisation for worsening heart failure occurred in 28.5% of the catheter ablation (CA) group versus 44.6% of the medical therapy (MT) group after a median follow-up of 37.8 months (HR: 0.62; 95% CI 0.43 to 0.87).

Sierra and colleagues’ frustration with p values …

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  • Contributors MM is the sole author and guarantor.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.