Evaluating Tools for Assessing Bias in a Meta-Analysis of Clinical Trials on Race and RAS Blockade

To the Editor A recent article evaluated the efficacy of renin-angiotensin system (RAS) blockade in patients with heart failure by race, using both 1-stage and 2-stage meta-analyses, dose-response analyses, and cumulative hazard estimates. However, we have several concerns about racial classifications, Grading of Recommendations Assessment, Development, and Evaluation (GRADE) assessments, and the credibility of the reported subgroup effects.