I am in Berlin at the European Heart Rhythm Society meeting. Sadly, this meeting conflicts with the American College of Cardiology meeting in Atlanta. ACC has produced a bunch of trials worthy of consideration. Since I have duties here at EHRA, I will defer this Monday’s Study of the Week to my friend Vinay Prasad who has an incredible video appraising the REDUCE-AMI study.
Right on with every point. Quality metrics should be completely abandoned for all the reasons given. In addition, can you imagine all the various interests that would have a large financial and/or reputational stake in establishing and maintaining their favored "metrics".
Does even one cardio guy address the problems that create negative heart conditions in the first place? This is why no matter how many "improvements" come along, cardiology will still be a stone age medical endeavor. More tests, procedures and drugs do not change anything. Except increase the income, revenues and profits. The root causes of heart failures are ignored and this insures a steady lineup of patients into the foreseeable future. No thanks.
The titration off BB is very interesting aspect. How did it pass IRB? Or was there really equipoise? It's a pretty bold move to titrate off of BB if that is standard of care.
It's the kind of gimmick that arguable is often to used to promote a new drug by making control group less than SoC. Although here if there is bias toward less is more minimalism we may wink so long as it turns out ok, which is problematic.
VP notes the conundrum but it raises important ethical questions of how to ethically show less is more after the horse is out of the barn.
Right on with every point. Quality metrics should be completely abandoned for all the reasons given. In addition, can you imagine all the various interests that would have a large financial and/or reputational stake in establishing and maintaining their favored "metrics".
His comments on quality metrics needs to be shouted from the rooftops... especially since they are antithetical to true shared decision making
Does even one cardio guy address the problems that create negative heart conditions in the first place? This is why no matter how many "improvements" come along, cardiology will still be a stone age medical endeavor. More tests, procedures and drugs do not change anything. Except increase the income, revenues and profits. The root causes of heart failures are ignored and this insures a steady lineup of patients into the foreseeable future. No thanks.
The titration off BB is very interesting aspect. How did it pass IRB? Or was there really equipoise? It's a pretty bold move to titrate off of BB if that is standard of care.
It's the kind of gimmick that arguable is often to used to promote a new drug by making control group less than SoC. Although here if there is bias toward less is more minimalism we may wink so long as it turns out ok, which is problematic.
VP notes the conundrum but it raises important ethical questions of how to ethically show less is more after the horse is out of the barn.