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The current evidence base supporting surgical therapy for infectious endocarditis consists of observational studies, which are prone to confounding by both measured and unmeasured factors and to survival bias (i.e., the longer patients survive, the more likely they are to undergo surgery). In this prospective study involving 1552 patients with native valve endocarditis, investigators used propensity scores to account for measured confounders; an instrumental variable intended to account for unmeasured confounders; and survival time matching to account for survival bias.
The analyses were limited to first episodes of definite native valve endocarditis (according to modified Duke criteria) in either right- or left-sided valves. Intravenous dru…