Need for Randomized Controlled Trial

We thank Kawano et al1 for their interesting article about the association between intraosseous vascular access and lower survival and worse neurologic outcome in out-of-hospital cardiac arrest. However, we are concerned that the study has not accounted for important selection biases or other possible cofounding factors between the intraosseous vascular access group and the intravenous vascular access group despite the propensity score matching.

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