Barack Obama, cardiologist? Not yet, but he spoke to the AMA today and delved briefly into the world of cardiology. Here is the relevant portion of his speech:
“…too many doctors and patients are making decisions without the benefit of the latest research. A recent study, for example, found that only half of all cardiac guidelines are based on scientific evidence. Half. That means doctors may be doing a bypass operation when placing a stent is equally effective, or placing a stent when adjusting a patient’s drugs and medical management is equally effective – driving up costs without improving a patient’s health.”
Update: Since Obama clearly referenced COURAGE in his talk, we thought we’d ask COURAGE PI Bill Boden for a response to Obama’s speech. Here are his thoughts:
“What you can say is that the President has clearly signaled that we must re-prioritize what we have been doing in U.S. healthcare. We must re-allocate healthcare $$ to disease prevention (lifestyle intervention, risk factor identification and optimal control of blood pressure, lipid, and other treatment targets), we must re-align incentives for reimbursement with the scientific evidence that supports it, and we must invest more research $$ in comparative effectiveness investigation so that we can establish which treatment options may give us a bigger bang for buck in terms of improving clinical outcomes, reducing death, and avoiding re-admissions to hospital. It’s a tall order–and he will be severely challenged by those who may seek to trivialize, demonize, and denigrate all of this as ‘socialized medicine’.”
You can find a full transcript of Obama’s speech on health care reform at the Wall Street Journal Health Blog.
You don’t need an MD to know unnecessary procedures are taking place.
I think he is referring to the following study:
Tricoci et al., Scientific Evidence Underlying the ACC/AHA Clinical Practice Guidelines. JAMA. 2009;301(8):831-841.