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LETTER TO THE EDITOR
PHASES and the natural history of unruptured aneurysms: science or pseudoscience?
  1. G J E Rinkel1,
  2. A Algra1,2,
  3. J P Greving2,
  4. M D I Vergouwen1,
  5. N Etminan3
  1. 1Department of Neurology and Neurosurgery, Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
  2. 2Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
  3. 3Department of Neurosurgery, University Hospital Mannheim, University of Heidelberg, Mannheim, Germany
  1. Correspondence to Dr G J E Rinkel, Department of Neurology and Neurosurgery, Brain Centre Rudolf Magnus, University Medical Center Utrecht, PO Box 85500, GA Utrecht 3508, The Netherlands; G.J.E.Rinkel{at}umcutrecht.nl

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We thank Dr Darsaut et al1 for their attention paid to the PHASES score and for sharing their thinking in an opinion paper 2 years after the publication of our article.2 The authors discuss whether or not prediction modeling based on data from previous observational studies is science. Their final conclusion is that the only valid way to decide whether or not unruptured aneurysms should be treated is to compare outcomes in patients eligible for both options (ie, aneurysm occlusion …

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