In this age of misinformation, where we seem to have become disdainful of genuine experts, no armor will protect us from folly more effectively than a healthy dose of disbelief.
The Curious Case of Using Beta-Blockers in HFrEF may turn on the Patient's Rhythm
The Study of the Week stays with the theme of applying trial evidence to patients, once again in the heart failure field. Perhaps GDMT might not always apply?
Implantable cardiac defibrillators (ICDs)can save lives if a person goes into a shockable rhythm (VT or VF), which would otherwise progress to impaired perfusion and death (termed sudden cardiac death - SCD), but instead, the ICD shocks them back to sinus rhythm.
Things are pretty quiet in the summer so let's go back to an old-school medical reversal in electrophysiology. One I lived through. If you like trials you will like this story
Friday Reflection 62: The Ethics of Telling Patients We Have Nothing Left to Offer
We no longer conceal bad diagnoses from patients; we consider this unethical. It is time that we consider it unethical to conceal that we have nothing to offer beyond palliation.
The SNAP Trial Exemplifies What EBM Should Look Like
It's always worth showing properly designed and conducted trials--though it's bad for pageviews. Nonetheless, SNAP authors show the way to answering questions in biomedicine
The calendar has turned to June, another class of medical students has graduated, and they will soon begin their residency training. What better time to dish out some unsought advice.
For Hospital Medicine, the Answer Should Always be: Randomize
I call them therapeutic fashions, things that we do because it's fashionable and popular. This week three of these were busted by...what else...the RCT
Medicine must improve because we want to treat the sick better and because we need to keep up with the new diagnoses being created that turn healthy people into patients.
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.
ChatCPR: AI’s Answer to the Question ‘When Will It Save Lives?’
In the US, fewer than 1 in 10 people who have cardiac arrest outside the hospital survive. Read this summary of a research team's attempt to use AI to save lives.
The ANTHEM HFrEF trial of vagal nerve stimulation was proceeding well when the sponsor stopped the trial. The story...and some thoughts about the research enterprise
If not for placebo procedures, you might be getting holes drilled into your heart
Two weeks ago, I wrote about how brave orthopedic surgeons saved many people from needless knee surgery. Yet cardiologists may be the bravest group of doctors when it comes to use of placebo trials
When does shared decision-making mean recommending ineffective therapies?
What is the differential efficacy between a good treatment and a less good treatment that allows a doctor to completely forgo discussion of the inferior treatment?
Public health messaging around the hantavirus cruise ship outbreak has been, ‘there is an extremely low risk to the general public,’ but this is suboptimal.
AI’s challenge to the medical profession requires us to think deeply about what it means to care for patients. The machines sound like they care. The question is whether we can help humans care for real.
No appearances yet. If you've seen Adam Cifu as a guest somewhere, hit + suggest to add it.
