Imperitia culpae adnumeratur.

he Randomized On Versus Off Bypass (ROOBY) Tstudy group has produced another interesting article [1]. They used complex and appropriate analytic methods in a cost-effectiveness study of the ROOBY trial [2]. This randomized control trial compared on-pump coronary artery bypass graft surgery (CABG) and off-pump coronary artery bypass graft surgery (OPCABG) in a large cohort of low-risk male patients within the US Veterans Administration Hospital system. The years of work invested in this project demand our attention but should withstand a critical reading. This paper studies the cost effectiveness over 1 year of both alternative therapies. The calculations start from an activity-based cost accounting system; additional costs were adjusted by prorating nonsurgical costs to overall length of stay. In this editorial, we will dissociate the analytic method from the costs incurred and studied. The analytic concept and method is irreproachable and the general concept of including in a major trial the economic aspects merits attention and praise.