RT Journal A1 DiNicolantonio JJ, O’Keefe JH, Lavie CJ T1 BEnefits and risks of aspirin use JF JAMA JO JAMA YR 2012 FD September 19 VO 308 IS 11 SP 1088 OP 1089 DO 10.1001/2012.jama.10717 UL http://dx.doi.org/10.1001/2012.jama.10717 AB To the Editor: Ms De Berardis and colleagues1 stated, “The benefit of aspirin for the primary prevention of cardiovascular events is relatively small for individuals with and without diabetes. This benefit could easily be offset by the risk of hemorrhage.” We disagree with their conclusion that aspirin use is associated with harm (major gastrointestinal or cerebral bleeding episodes) because they conducted a population-based cohort study, not a randomized controlled trial (RCT), and thus cannot prove causation.1