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Disagreements were large (relative RR 1.43) in 68 (54%) and statistically significant in 12 (9%) of the comparisons. The degree of agreement varied among reviews but was not strongly associated with intervention or outcome characteristics. DISCUSSION Disagreements between observational studies using propensity score methods and randomized trials can occur for many reasons and the available data cannot be used to discern the reasons behind specific disagreements. Better benchmarking of observational analyses using propensity scores (and