I’m not a doctor but I thought I knew something about anticoagulation. Over the course of a career covering cardiology I’ve written countless stories about heparin, warfarin, the low molecular weight heparins, and the new oral anticoagulants. So when I had bilateral total knee replacement a few weeks ago I thought I knew what to…
In Which I Go Under The Knife And Learn About Medicine In The Real World
January 27, 2017 by 7 Comments
Statin Trialists Seek To Bury Debate With Evidence
September 8, 2016 by 14 Comments
–A Lancet review claims overwhelming evidence in favor of statins for both primary and secondary prevention. Some disagree. A large group of statin researchers argue forcefully that the debate over statins should be ended because the evidence in favor of statins is overwhelming and incontrovertible. But some outsiders say the issue is more nuanced and…
The Big Dirty Secret Every Doctor Knows
August 2, 2016 by 5 Comments
–Eminence-based medicine is not the exception. It’s the rule. Lately I’ve been writing about eminence-based medicine (here, here, and here). In response to these posts Saurabh Jha, a well-known radiologist and health-policy critic, asked me on Twitter: “How do you find these utter gems?!” I was surprised by Jha’s question. At first I thought…
Pioneering Interventional Cardiologist Defends Unorthodox Practices
August 1, 2016 by 3 Comments
–Bernhard Meier explains why he seals plaques and thinks PFO closure is ‘the best procedure in interventional cardiology’ (Updated) Recently I wrote about an article by Bernhard Meier, a top interventional cardiologist, in which he rejected the idea that evidence based on randomized controlled trials should be the basis for the practice of interventional cardiology….
Interventional Cardiology And The Rejection Of Science
July 22, 2016 by 6 Comments
–Prominent interventional cardiologist says clinical trials are slowing progress In their eagerness to embrace a glorious future of ever more spectacular technology-based advances, interventional cardiology— a subspecialty never exactly known for caution, patience, or self reflection— is poised to reject science, evidence-based medicine, and randomized controlled trials. “Generating and publishing evidence is a tedious job,”…
Top HF Expert Decries ‘Unbelievable Folly’ of Clinical Trials and Guidelines
March 23, 2016 by Leave a Comment
–Milton Packer, MD, calls the system to test and evaluate heart failure drugs dysfunctional The system is completely broken, writes heart failure specialist Milton Packer, MD, in an editorial in Circulation: Heart Failure. The results of important clinical trials are not being incorporated into guidelines quickly, intelligently, or consistently, Packer argued. The most important reason…
Missing High Blood Pressure Guideline Turns Up In JAMA
December 18, 2013 by Leave a Comment
After years of delay and many twists and turns, the hypertension guideline originally commissioned by the NIH has now finally been published in JAMA. The evidence-based document contains a major revision of hypertension treatment targets and includes new and somewhat simplified recommendations for drug treatment. The previous US hypertension guideline was published more than a decade ago….
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