The worst abuse of an embargo this medical journalist has ever seen

Meds
September 12, 2011

In general I support embargoes in medical journalism. Although the current system is far from perfect and contains all sorts of wrinkles and unexpected consequences, I support the system because it allows journalists a bit more time to work on complicated stories and to try to get them right. Recently, though, I came across the single worst abuse of an embargo that I have encountered in the course of my …

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The worst abuse of an embargo this medical journalist has ever seen

The official response to Mark Midei is not satisfactory

Physician
June 20, 2011

For more than a year now, as most CardioBrief readers undoubtedly know, a scandal in Maryland has raised troubling questions about hundreds of stent patients treated by Mark Midei —  previously considered one of the top interventional cardiologists in the state. In the wake of the scandal, some have questioned whether other interventional cardiologists, in Maryland and elsewhere, may also have routinely performed unnecessary procedures.

Of course, no one …

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The official response to Mark Midei is not satisfactory

How academic physicians are being used as live bait for journalists

Physician
April 3, 2011

Here’s something little known outside of the small circle of industry marketers, academic docs, PR flacks, and medical journalists: pharmaceutical and device companies (or their PR agencies) regularly offer to arrange interviews with well-known academic physicians to talk about new trials, drug approvals, and other items of obvious interest to the companies involved.

I receive these sort of invitations all …

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How academic physicians are being used as live bait for journalists

Dabigatran (Pradaxa) questions in atrial fibrillation

Patient
January 27, 2011

The approval of dabigatran (Pradaxa) has been long awaited in the cardiology community. Although just about everyone agrees that a good alternative to warfarin is highly desirable, there are many remaining questions about the drug as it prepares to enter the marketplace.

Here are a few questions raised by electrophysiologist John Mandrola on his blog:

  • In the RE-LY trial, dabigatran was used twice daily.  When not symptomatic, patients often find …

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Dabigatran (Pradaxa) questions in atrial fibrillation

Suspicious withdrawal of a publication from an academic journal

Physician
November 30, 2010

The official ESC journal Europace publishes an online case report by Dr. Martin Hudec about the extremely rare and spectacular failure of a recently implanted Biotronik 340 VR-T ICD in a 46-year-old man. The battery of the device apparently overheated, causing the device to malfunction and leading to severe internal burning.

On Wednesday, October 6, US electrophysiologist Westby Fisher summarizes the Europace article on his blog and reprints several extremely gruesome pictures …

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Suspicious withdrawal of a publication from an academic journal

Avandia aftermath: winners and losers

Meds
October 11, 2010

Responses to the Avandia panel have been all over the map, as cleverly noted on the Wall Street Journal‘s Health Blog. Avandia is “dead” (Forbes), or, perhaps worse, “now a Zombie” (BNET). By contrast, others thought the panel granted Avandia a “reprieve” (Wall Street Journal and that Avandia would now probably be allowed to stay on the market (Los Angeles Times, Pharmalot).

All these views are …

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Avandia aftermath: winners and losers

Why a marketing study for Niaspan was published in a medical journal

Meds
September 3, 2010

The authors call it “an in-office linguistic study” and write that it “was conducted to assess physician–patient discussions of mixed dyslipidemia.” But it’s really an Abbott marketing study for Niaspan, the company’s long-acting niacin product, and the question is: why is it published in the American Journal of Cardiology?

The study involves the recorded conversations of 12 cardiologists and 12 PCPs with 45 patients with low levels of HDL. The authors …

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Why a marketing study for Niaspan was published in a medical journal

Unread echocardiogram fallout at Harlem Hospital Center

Conditions
August 3, 2010

Recently, the New York Times reported that Harlem Hospital Center had finally completed its investigation into thousands of echocardiograms that after receiving an initial reading by a technician had never been read by a physician.

It turns out that out of 7,000 tests that went unread, only 14 patients “might have been misdiagnosed because their tests had not been handled properly,” according to the hospital spokeswoman quoted in the story. …

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Unread echocardiogram fallout at Harlem Hospital Center

Physicians have no excuse for years of unread echocardiograms

Physician
July 3, 2010

At least 200 patients whose echocardiograms went unread by a cardiologist for as long as three years have died, according to a new article in the New York Times by Anemona Hartocollis.

Equally troubling, a cardiologist reading some of the tests says that he has found “life-threatening diagnoses” on some of the tests.

The Times reports that medical officials said that “none of those patients needed ‘follow-up care.” But the cardiologist, …

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Physicians have no excuse for years of unread echocardiograms

Peer review may require random over-reads

Conditions
June 9, 2010

“Let’s kill all the lawyers.” It’s every doctor’s favorite Shakespeare quote. And if you’re giving a talk to doctors there’s no better way to get the audience on your side than by starting with a lawyer joke.

But perhaps we shouldn’t be too hasty about killing all those lawyers. As recent commentary about the Mark Midei case makes clear, modern medicine doesn’t know how to police itself. And until medicine does …

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Peer review may require random over-reads

Why rosiglitazone would not have been approved today

Meds
March 7, 2010

Avandia continues to dominate cardiovascular-related news this week. Recently, the AHA and the ACC issued a highly detailed, thoughtful, though perhaps slightly over-diplomatic science advisory on TZDs and CV risk. Taking a completely opposite tack, GSK, in no mood to take prisoners, and apparently about to nominate itself for a Nobel Prize, issued a 30 page White Paper in response to the Senate report published on Saturday.

At the core …

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Why rosiglitazone would not have been approved today

Treating atrial fibrillation with catheter ablation on TV may not be ethical

Conditions
February 17, 2010

Mauricio Arruda performed a live atrial fibrillation ablation at University Hospitals in Cleveland on the Today Show recently.

The 6-minute segment was relentlessly upbeat. The TV producers pulled every trick in the book to overcome the inherent difficulty of portraying a hard-to-explain disease like atrial fibrillation and an even harder-to-explain procedure like catheter ablation. Instead of making any effort to truly educate their viewers, the producers took the easy …

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Treating atrial fibrillation with catheter ablation on TV may not be ethical

Will there really be an impending shortage of cardiologists?

Policy
September 28, 2009

There can be little doubt that the lethal combination of aging baby boomers, the obesity epidemic, and the growing success of medical and interventional therapies for CV disease (resulting in more and more survivors of major events) is going to produce a flood of cardiovascular disease in the coming decades, and cardiologists in great numbers will be needed to care for these people.

However, that doesn’t mean that the message conveyed …

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Will there really be an impending shortage of cardiologists?