John, thank you for sharing. I find it frightening how hard many Cardiologists are pushing Watchmans. And it’s frightening either because of the financial incentives or because they just aren’t thinking about what they do. As a PCP, I’m not sure what to do except tell my patients not to get it (and then give them printed copies of these trials to share with their cardiologist. Passive aggressive, but that’s all I’ve got). The other issue is that bleeding risk are very similar between NOACs and aspirin (trials show mixed results which probably says they’re similar, but AVERROES is an example), and so right out the window goes the logic to do the procedure so someone can be on aspirin instead of a NOAC.
Financial incentive for the implanters. No need to make it more complicated than that.
The more disturbing aspect is the dereliction of duty by the regulator(s). How do you approve a device that has such flimsy evidence of efficacy and safety?
John, these studies demonstrate that the skepticism you and others had regarding these devices was more than justified. If these manufacturers want our trust they will have to earn it. They have yet to earn it.
I was naively eager to be part of the Watchman trial program at UBC years ago. Glad I wasn't accepted, even with chronic afib and chf, one reason being blood transfusion refusal. It would be very interesting to hear your comments on 'that' very common procedure sometime also.?
Amazing that just such a study was allowed inside the woked medical establishment. This also questions why the corrupted minimal at best COVID vac studies on mice were allowed to deduce human effectiveness. If we had such a complete review of this vac thousands and thousands of adults and kids would be with us now whether their Souls or their disabled persons. If only the FDA was really interested in OUR health and safety.
Do you have any trials or information about low back fusion surgery that discuss its pros and cons? Thank you for this stroke study and your newsletter but I’d really like more research on these back surgeries.
Thanks George for mansplaining my condition as if the radicular and correlative imaging hasn’t already been done. Appreciate the response though or do I!🤷♀️🤷🏿♀️🤷🏿♀️🤷🏻♀️
I trust my herbalist, who passed away 40 years ago, more than these money hungry cardio boys. You medicos are locked into surgeries, drugs and procedures which are no better than herbs, vitamins and minerals and a few other helpful lifestyle practices. You just want us to believe they are.
"Proponents of the device argue that SWISS APERO results may not be that bad...." So that's the criteria now for recommending a procedure? It's not THAT bad.... The fact that not many doctors who advocate the procedure will stop doing it is not surprising, and I admire Dr. Reddy for resisting confirmation bias, the more typical reaction. I hope every medical student is now required to take a course in cognitive biases (link below) and how they can influence data selection and interpretation. I also hope you write an article for lay persons with a list of questions they can ask their doctor before agreeing to any type of treatment.
John, thank you for sharing. I find it frightening how hard many Cardiologists are pushing Watchmans. And it’s frightening either because of the financial incentives or because they just aren’t thinking about what they do. As a PCP, I’m not sure what to do except tell my patients not to get it (and then give them printed copies of these trials to share with their cardiologist. Passive aggressive, but that’s all I’ve got). The other issue is that bleeding risk are very similar between NOACs and aspirin (trials show mixed results which probably says they’re similar, but AVERROES is an example), and so right out the window goes the logic to do the procedure so someone can be on aspirin instead of a NOAC.
Financial incentive for the implanters. No need to make it more complicated than that.
The more disturbing aspect is the dereliction of duty by the regulator(s). How do you approve a device that has such flimsy evidence of efficacy and safety?
John, these studies demonstrate that the skepticism you and others had regarding these devices was more than justified. If these manufacturers want our trust they will have to earn it. They have yet to earn it.
I was naively eager to be part of the Watchman trial program at UBC years ago. Glad I wasn't accepted, even with chronic afib and chf, one reason being blood transfusion refusal. It would be very interesting to hear your comments on 'that' very common procedure sometime also.?
Amazing that just such a study was allowed inside the woked medical establishment. This also questions why the corrupted minimal at best COVID vac studies on mice were allowed to deduce human effectiveness. If we had such a complete review of this vac thousands and thousands of adults and kids would be with us now whether their Souls or their disabled persons. If only the FDA was really interested in OUR health and safety.
Data supports intervention X ... "Let's do it!"
Data does NOT support intervention X ... "Let's do it!"
The incentives (money, cognitive certitude) drive most professional behavior. Science is a weak lever. Sad.
Amazing results. It's also good to see an honest assessment from a specialist.
The situation reminds me of the way clinical diagnostics commonly fail:
https://rayhorvaththesource.substack.com/p/diagnostic-failures-reveal-inadequacies
Dr. Prassad had similar problems with bone marrow transplants yesterday:
https://rayhorvaththesource.substack.com/p/bone-marrow-transplant-to-fix-rbc
Do you have any trials or information about low back fusion surgery that discuss its pros and cons? Thank you for this stroke study and your newsletter but I’d really like more research on these back surgeries.
Most “good” back surgeons are loath to operate on chronic back pain in absence of radicular symptoms and correlative imaging.
Thanks George for mansplaining my condition as if the radicular and correlative imaging hasn’t already been done. Appreciate the response though or do I!🤷♀️🤷🏿♀️🤷🏿♀️🤷🏻♀️
I trust my herbalist, who passed away 40 years ago, more than these money hungry cardio boys. You medicos are locked into surgeries, drugs and procedures which are no better than herbs, vitamins and minerals and a few other helpful lifestyle practices. You just want us to believe they are.
Complete satisfaction (100% closure) or it's free...it's always 'follow the money'...
"Proponents of the device argue that SWISS APERO results may not be that bad...." So that's the criteria now for recommending a procedure? It's not THAT bad.... The fact that not many doctors who advocate the procedure will stop doing it is not surprising, and I admire Dr. Reddy for resisting confirmation bias, the more typical reaction. I hope every medical student is now required to take a course in cognitive biases (link below) and how they can influence data selection and interpretation. I also hope you write an article for lay persons with a list of questions they can ask their doctor before agreeing to any type of treatment.
https://journalofethics.ama-assn.org/article/believing-overcoming-cognitive-biases/2020-09
Wow! Thank you, John. That makes for a jarring read!