Abstract
In the article by Backes et al.,1 the primary outcome was defined as greater than 1 mm growth as measured at local sites. The use of this cutoff was not referenced and a 1 mm change could be subject to potential measurement error. Furthermore, if different imaging modalities in one patient (magnetic resonance angiography vs CT angiography) were used to measure growth, their results could also lead to measurement error. An additional source of error and bias is if the physician carrying out the measurement was aware of the prior size. In that instance, the interpreting physician may judge an aneurysm that is larger to be more likely to grow, thereby biasing measurement. The potential sources of measurement error and bias may affect the results; it would be helpful to know if there was a blinded central reading center.
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