The implantable loop recorder is pretty amazing little tool. It provides a lot of data. But data are not outcomes. And, as it turns out, reducing outcomes is not so easy.
My PhD advisor had a saying: “Another great idea shot down by clear data.” Models are just that - creations of the investigator to make sense of available data. When the model does not fit the data, it’s time to kick it to the curb and think anew.
Very interesting. Another downside to having them is that I’m pretty sure they prevent a patient from getting an MRI. Can they be removed as easily as they are implanted?
I had a stroke 3 weeks ago. Heart rhythm was regular during 4 days of hospitalization. I suppose I should expect post-hospitalization follow up to include a physician order to use a loop recorder or Zia patch to check for sub clinical AF . I will skip that one.
I see this as an excellent example of the corruption of researchers. They seem desperate to spin a positive outcome from a worse than neutral outcome. (The outcome curves have a massive delta indicating harm from the device, even if the low numbers mean they didn't reach statistical significance.) Yet, the researchers still want to make it look good.
No neutral observer would ever come to these conclusions. A skeptic would rake the research team over the coals.
Excellent as always. Another proof to what I’ve been teaching my trainees for years, “the heart is too important an organ to be left to a cardiologist.”
Again, a triumph of technology over reason. An electronic scale and FaceTime and a nurse is worth a room full of cardiologists. Practicing in Lampasas small town we would have the elderly people come back who didn’t have family to check on them more frequently. They almost didn’t need to be seen. They just needed to walk into the waiting room to have the nurse eyeball them and their feet and send them on their way. The intravascular implantable pressure monitors seem to at least have a medical reason why you might pick up changes before you see the edema. A story involving my dad -at age 96 -he gets admitted in September 2024 hypertensive heart failure troponin of 10. Gets usual IV lasix drip. Moves closer to our home goes into assisted living and now gets the usual decent medical therapy. He weighs 190 down from 240 has zero edema. PT says he can walk 1600 feet with his WALKER do the math on that-still in slow a fib on anticoagulation. He has had no hospitalization for heart failure other things but not heart failure for two years. What changed?
Nursing care , son to check on him in person; meds handed to him daily and the lack of a car to go to Dunkin’ Donuts and McDonald’s. The the latter is probably ranked the highest.
My PhD advisor had a saying: “Another great idea shot down by clear data.” Models are just that - creations of the investigator to make sense of available data. When the model does not fit the data, it’s time to kick it to the curb and think anew.
Very interesting. Another downside to having them is that I’m pretty sure they prevent a patient from getting an MRI. Can they be removed as easily as they are implanted?
Wow you cannot make this stuff up. "Cash cow" for sure . Thanks for sharing my what the danes do and for bringing this trial to our attention
I had a stroke 3 weeks ago. Heart rhythm was regular during 4 days of hospitalization. I suppose I should expect post-hospitalization follow up to include a physician order to use a loop recorder or Zia patch to check for sub clinical AF . I will skip that one.
I see this as an excellent example of the corruption of researchers. They seem desperate to spin a positive outcome from a worse than neutral outcome. (The outcome curves have a massive delta indicating harm from the device, even if the low numbers mean they didn't reach statistical significance.) Yet, the researchers still want to make it look good.
No neutral observer would ever come to these conclusions. A skeptic would rake the research team over the coals.
The spin of a clearly negative outcome is by far the most nauseating part.
And to try to suggest a subgroup benefit….out of a negative trial….is just mind boggling.
Excellent as always. Another proof to what I’ve been teaching my trainees for years, “the heart is too important an organ to be left to a cardiologist.”
KETTERER MW. (2019). Cochrane’s Brake: Randomized Controlled Trials & the
Doctor’s Pen. Researchgate. DOI: 10.13140/RG.2.2.20553.90723
Should be required reading for those that worship at the altars of the microchip and AI.
Again, a triumph of technology over reason. An electronic scale and FaceTime and a nurse is worth a room full of cardiologists. Practicing in Lampasas small town we would have the elderly people come back who didn’t have family to check on them more frequently. They almost didn’t need to be seen. They just needed to walk into the waiting room to have the nurse eyeball them and their feet and send them on their way. The intravascular implantable pressure monitors seem to at least have a medical reason why you might pick up changes before you see the edema. A story involving my dad -at age 96 -he gets admitted in September 2024 hypertensive heart failure troponin of 10. Gets usual IV lasix drip. Moves closer to our home goes into assisted living and now gets the usual decent medical therapy. He weighs 190 down from 240 has zero edema. PT says he can walk 1600 feet with his WALKER do the math on that-still in slow a fib on anticoagulation. He has had no hospitalization for heart failure other things but not heart failure for two years. What changed?
Nursing care , son to check on him in person; meds handed to him daily and the lack of a car to go to Dunkin’ Donuts and McDonald’s. The the latter is probably ranked the highest.
Sensible Medicine!